Individual
SALLY M FIFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
300 9TH ST, HENDERSON, KY 42420-2751
(270) 827-8681
(270) 826-7687
Mailing address
300 9TH ST, P O BOX 595, HENDERSON, KY 42420-2751
(270) 827-8681
(270) 826-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1017DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190215
ANTHEM
KY
01
—
0675230001
PALMETTO
KY
05
—
7100121660
—
KY
Enumeration date
12/08/2006
Last updated
08/09/2011
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