Provider Demographics
NPI:1538265798
Name:PAUL D. RALPH, D.C. PLLC
Entity type:Organization
Organization Name:PAUL D. RALPH, D.C. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:RALPH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-955-1449
Mailing Address - Street 1:815 JOHN HARPER HWY.
Mailing Address - Street 2:SUITE 10
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7463
Mailing Address - Country:US
Mailing Address - Phone:502-955-1449
Mailing Address - Fax:502-955-1471
Practice Address - Street 1:815 JOHN HARPER HWY.
Practice Address - Street 2:SUITE 10
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7463
Practice Address - Country:US
Practice Address - Phone:502-955-1449
Practice Address - Fax:502-955-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4323111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6079701Medicare PIN