Individual
SARA MOREDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
191 DOCTORS DR, FRANKFORT, KY 40601-4101
(502) 223-2182
Mailing address
191 DOCTORS DR, FRANKFORT, KY 40601-4101
(502) 223-2182
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
06/17/2015
Last updated
06/24/2015
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