Individual
MARY J ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5129 DIXIE HWY STE 100, LOUISVILLE, KY 40216-1727
(502) 447-3242
(276) 679-6095
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05172
KY
390200000X
Student in an Organized Health Care Education/Training Program
0116033269
VA
Other
Enumeration date
06/25/2019
Last updated
06/01/2022
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