Individual
SAMUEL CORYELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3605 FERN VALLEY RD, LOUISVILLE, KY 40219-1916
(502) 964-4889
Mailing address
2600 MEADOW RD, LOUISVILLE, KY 40205-2222
(502) 494-0949
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC222
KY
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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