Individual
LISA NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1707 CUMBERLAND FALLS HWY STE U4, CORBIN, KY 40701-2744
(606) 528-7336
Mailing address
1707 CUMBERLAND FALLS HWY STE U4, CORBIN, KY 40701-2744
(606) 528-7336
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
110149
KY
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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