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Individual

JEFFERY JACOB BANFIELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.T.(R)

Contact information

Practice address
17 AMBER DR, CORBIN, KY 40701-9406
(606) 545-8154
Mailing address
17 AMBER DR, CORBIN, KY 40701-9406
(606) 545-8154

Taxonomy

Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
564972
KY

Other

Enumeration date
02/23/2021
Last updated
03/02/2021
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