Individual
JOYCE C PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1937 OLD MAIN ST, SUITE 2, MAYSVILLE, KY 41056-8956
(606) 759-7311
(606) 759-0610
Mailing address
PO BOX 54, WASHINGTON, KY 41096-0054
(606) 564-8794
(606) 759-0610
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
111468
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063563104
EMPLOYEE - IP
KY
01
—
1093159626
NPI-ADAM BRADLEY
KY
05
—
5200015500
—
KY
01
—
60537045
BLUE CROSS BLUE SHIELD
KY
05
—
7100022560
—
KY
Enumeration date
08/30/2005
Last updated
01/31/2018
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