Individual
HOLLY MARIE WORKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 RYANS WAY, DRY RIDGE, KY 41035-7062
(502) 514-7147
Mailing address
125 RYANS WAY, DRY RIDGE, KY 41035-7062
(502) 514-7147
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4286
CERTIFICATION
KY
Enumeration date
06/05/2019
Last updated
06/05/2019
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