Individual
LISA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 765-6106
Mailing address
1101 WOODLAND DR, ELIZABETHTOWN, KY 42701-2749
(270) 765-6106
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
A2449
KY
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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