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Individual

STEPHANIE A HART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5925 LOUISVILLE RD, BOWLING GREEN, KY 42101-8473
(270) 320-4458
Mailing address
5925 LOUISVILLE RD, BOWLING GREEN, KY 42101-8473
(270) 320-4458

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
88-0807210
KY
Enumeration date
04/07/2022
Last updated
04/07/2022
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