Provider Demographics
NPI:1164657797
Name:LAFERTY CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:LAFERTY CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/D.C.
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:606-375-9395
Mailing Address - Street 1:792 SOUTH HWY 160
Mailing Address - Street 2:
Mailing Address - City:HINDMAN
Mailing Address - State:KY
Mailing Address - Zip Code:41822
Mailing Address - Country:US
Mailing Address - Phone:606-375-9395
Mailing Address - Fax:606-447-2299
Practice Address - Street 1:792 SOUTH HWY 160
Practice Address - Street 2:
Practice Address - City:HINDMAN
Practice Address - State:KY
Practice Address - Zip Code:41822
Practice Address - Country:US
Practice Address - Phone:606-375-9395
Practice Address - Fax:606-447-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty