Individual
RAVEN SYMONE VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 CENTRAL AVE STE 201, LOUISVILLE, KY 40208-1451
(502) 637-7678
Mailing address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 585-9911
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
12/08/2022
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