Individual
UNKNOWN PAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT KENTUCKY #0048
Contact information
Practice address
116 ARTERBURN DR, LOUISVILLE, KY 40222-4855
(502) 314-3254
Mailing address
116 ARTERBURN DR, LOUISVILLE, KY 40222-4855
(502) 314-3254
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0048
KY
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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