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Individual

KELLY EVERSOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
601 PERIMETER DR, SUITE 100, LEXINGTON, KY 40517-4121
(859) 257-4576
Mailing address
1041 KIAWAH DR, LEXINGTON, KY 40515-1195

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004477
KY

Other

Enumeration date
06/05/2011
Last updated
06/05/2011
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