Healthsource of Southeast Lexington Inc.

NPI #1104081306 in Lexington, Kentucky

Provider Information

NPI Number: 1104081306
Entity Type: Organization
Organization Name: Healthsource of Southeast Lexington Inc.
Primary Specialty: Chiropractor
Enumeration Date: Jul 28, 2008
Last Updated: Nov 18, 2009

Practice Location

Address: 4101 TATES CREEK CENTRE DR
Address 2: SUITE 132
City: Lexington
State: Kentucky
ZIP Code: 40517-3066
Phone: (859) 272-5460

Authorized Official

Name: DR. MICHAEL NEWELL PUGH, D.C.
Title: CHIROPRACTOR
Phone: (859) 272-5460

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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