Individual
MICHELLE COLLINS BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
803 MEYERS BAKER RD, SUITE 200, LONDON, KY 40741-3039
(606) 878-4300
(606) 878-4308
Mailing address
803 MEYERS BAKER RD, SUITE 200, LONDON, KY 40741-3039
(606) 878-4300
(606) 878-4308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1581
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100025690
—
KY
Enumeration date
09/29/2010
Last updated
02/05/2014
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