Individual
JOE V MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
237 E 6TH ST, RUSSELLVILLE, KY 42276-1917
(270) 726-3629
(270) 726-3620
Mailing address
308 WALNUT ST, AUBURN, KY 42206-5126
(270) 726-3629
(270) 726-3620
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0548
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
Enumeration date
02/08/2007
Last updated
07/08/2007
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