Provider Demographics
NPI:1174750996
Name:UNION CHIROPRACTIC INJURY & REHABILITATION CENTER
Entity type:Organization
Organization Name:UNION CHIROPRACTIC INJURY & REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HAGAR
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:GOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-964-1888
Mailing Address - Street 1:5400 PRESTON HWY STE H
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-2835
Mailing Address - Country:US
Mailing Address - Phone:502-964-1888
Mailing Address - Fax:502-964-1878
Practice Address - Street 1:5400 PRESTON HWY STE H
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40213-2835
Practice Address - Country:US
Practice Address - Phone:502-964-1888
Practice Address - Fax:502-964-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty