Individual
JADE CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 TALLYHO WAY, ELIZABETHTOWN, KY 42701-7829
(270) 748-1824
Mailing address
100 TALLYHO WAY, ELIZABETHTOWN, KY 42701-7829
(270) 748-1824
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
BMTMTH00214650
KY
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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