Individual
JENNIFER VICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2355 POPLAR LEVEL RD STE 301, LOUISVILLE, KY 40217-1388
(502) 636-0406
(502) 636-5137
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
123191
KY
Other
Enumeration date
06/27/2019
Last updated
09/07/2023
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