Individual
MATTHEW MARCUS HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1365 DEVONPORT DR, LEXINGTON, KY 40504-1552
(859) 309-2240
Mailing address
1365 DEVONPORT DR, LEXINGTON, KY 40504-1552
(859) 309-2240
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1206188
KY
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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