Provider Demographics
NPI:1174158570
Name:CENTRAL KENTUCKY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:CENTRAL KENTUCKY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-319-5623
Mailing Address - Street 1:6350 LEBANON RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-9101
Mailing Address - Country:US
Mailing Address - Phone:859-319-5623
Mailing Address - Fax:
Practice Address - Street 1:448 LEWIS HARGETT CIR STE 220
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3596
Practice Address - Country:US
Practice Address - Phone:859-859-5237
Practice Address - Fax:859-523-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100676220Medicaid