OLDHAM COUNTY SPINE & REHAB CENTER PSC (NPI# 1689851602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689851602 |
| Entity Type | Organization |
| Organization Name | OLDHAM COUNTY SPINE & REHAB CENTER PSC |
| Other Organization Name | LAGRANGE CHIROPRACTIC & REHAB |
| Practice Address |
301 S 1st St Lagrange KY 40031-1240 |
| Practice Telephone | 5022220000 |
| Practice Fax Number | 5022223488 |
| Mailing Telephone | 5022220000 |
| Mailing Fax Number | 5022223488 |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-07-03 |
| Authorized Official Name | LIDO LEE PETRUCCI (OWNER) |
| Authorized Official Telephone | 5022220000 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| LaGrange Chiropractic & Rehab | Doing Business As Name - Organization |
| Street Address |
301 S 1ST ST |
| City | LAGRANGE |
| State | KY |
| Zip Code | 40031-1240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477679587 | Lagrange Chiropractic Psc | Chiropractor | 301 S 1st St, Lagrange, KY 40031 | 2007-03-21 |
| 1336243971 | Lido L Petrucci | Chiropractor | 301 S 1st St, Lagrange, KY 40031-1240 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669844296 | Chase Daniel Waggoner | Chiropractor | 400 Union St, Lagrange, IN 46761-2286 | 2015-10-22 |
| 1740547447 | Total Healthcare of Lagrange, LLC | Chiropractor | 3452 Hogansville Rd, Suite B, Lagrange, GA 30241-8269 | 2012-04-19 |
| 1760798128 | Matthew Tyler Wolfertz | Chiropractor | 1697 Vernon Rd Ste A, Lagrange, GA 30240-4180 | 2010-08-24 |
| 1275844227 | Life Style Enhancement Centers | Chiropractor | 3206 W Point Rd, Lagrange, GA 30240-7545 | 2010-06-24 |
| 1447409610 | Brenton Coe Jones | Chiropractor | 110 Elm Dr, Lagrange, GA 30240-1606 | 2008-09-12 |
| 1164682993 | John Herbert Kent Jr. | Chiropractor | 1505 Lafayette Pkwy, Lagrange, GA 30241-2513 | 2008-06-16 |
| 1235303686 | Atlas Neck & Back Center | Chiropractor | 309 N. Morgan St., Suite A, Lagrange, GA 30241 | 2008-04-16 |
| 1902074495 | Healthy Living Chiropractic, LLC | Chiropractor | 299 Commerce Ave Ste B, Lagrange, GA 30241-2345 | 2008-02-19 |
| 1083807481 | Holistic Chiropractic, LLC | Chiropractor | 299 Commerce Ave, Lagrange, GA 30241-2345 | 2007-08-20 |
| 1225173057 | Sadiyq Taylor | Chiropractor | 1003 Hogansville Rd, Suite G, Lagrange, GA 30241-1459 | 2007-02-20 |
| Find all providers in LAGRANGE | ||||
Please comment or provide details below to improve the information on OLDHAM COUNTY SPINE & REHAB CENTER PSC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.