Individual
OPAL PREVATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 BALL PARK RD, HARLAN, KY 40831
(606) 573-4520
Mailing address
37 BALL PARK RD, HARLAN, KY 40831-1701
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00000
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2015
Last updated
07/17/2018
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