Individual
MRS. LISA JO JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1149 SUNSHINE LN, KIMPER, KY 41539-6455
(606) 631-6564
Mailing address
1149 SUNSHINE LN, KIMPER, KY 41539-6455
(606) 631-6564
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
200002555
KY
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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