Provider Demographics
NPI:1265758254
Name:HEBRON CHIROPRACTIC II INC
Entity type:Organization
Organization Name:HEBRON CHIROPRACTIC II INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:859-308-2034
Mailing Address - Street 1:2030 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-7195
Mailing Address - Country:US
Mailing Address - Phone:859-372-0888
Mailing Address - Fax:206-333-1232
Practice Address - Street 1:2030 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-7195
Practice Address - Country:US
Practice Address - Phone:859-372-0888
Practice Address - Fax:206-333-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty