Individual
MR. WILLIAM JERNIGAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1860 MELLWOOD AVE STE 179, LOUISVILLE, KY 40206-1033
(502) 365-2022
Mailing address
8110 TERRY RD, LOUISVILLE, KY 40258-1732
(502) 314-9276
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
260894
KY
Other
Enumeration date
09/07/2020
Last updated
09/07/2020
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