Individual
SHAISTA VALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
740 S LIMESTONE, E300 KENTUCKY CLINIC, LEXINGTON, KY 40536-0001
(859) 323-5867
Mailing address
740 SOUTH LIMESTONE, E300 KENTUCKY CLINIC, LEXINGTON, KY 40536
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1997DT
KY
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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