Provider Demographics
NPI:1861657678
Name:LOUISVILLE SPINAL CARE INC
Entity type:Organization
Organization Name:LOUISVILLE SPINAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:ZEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:502-893-8887
Mailing Address - Street 1:147 CHENOWETH LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2652
Mailing Address - Country:US
Mailing Address - Phone:502-893-8887
Mailing Address - Fax:502-895-1916
Practice Address - Street 1:147 CHENOWETH LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2652
Practice Address - Country:US
Practice Address - Phone:502-893-8887
Practice Address - Fax:502-895-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50005853OtherPASSPORT
KY850003325Medicaid
KY000000269576OtherBLUE CROSS/BLUE SHIELD
KY850003325Medicaid
KY7578Medicare PIN