Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4862 | KY |
NPI | 1003952946 |
---|---|
Provider Name | Dr. Brandon Scott Meade |
First Address | Covington, KY 41017-0842 |
Second Address | Florence, KY 41042-5182 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 23/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9775 | (02) | KY |
U99059 | (02) | KY |