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Individual

GARY DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 435-0817
Mailing address
115 ROCKWOOD LN, HAZARD, KY 41701-9415
(606) 436-5761
(606) 435-0817

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1634
KY

Other

Enumeration date
02/21/2011
Last updated
05/01/2014
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