Individual
TIFFANY MARIA BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
4917 DIXIE HWY STE H, LOUISVILLE, KY 40216-2565
(502) 447-2020
Mailing address
4917 DIXIE HWY STE H, LOUISVILLE, KY 40216-2565
(502) 447-2020
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
111351
KY
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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