Individual
MRS. JENNIFER M WHEATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3615 NEWBURG RD, LOUISVILLE, KY 40218-3368
(502) 909-0772
(855) 859-0123
Mailing address
3047 RADIANCE RD, LOUISVILLE, KY 40220-1803
(603) 557-0044
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
227017962
IL
225700000X
Massage Therapist
Primary
284846
KY
Other
Enumeration date
11/12/2019
Last updated
01/17/2024
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