Individual
JACK STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 S LIMESTONE ST, LEXINGTON, KY 40503
(859) 323-1100
Mailing address
900 S LIMESTONE ST, LEXINGTON, KY 40503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
S20-311-367
KY
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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