Individual
DAVID JONATHON WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4922 POPLAR LEVEL RD, LOUISVILLE, KY 40219-1128
(502) 434-5566
Mailing address
30 CARROLL AVE, EMINENCE, KY 40019-1300
(502) 706-8643
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2049631
KY
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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