Individual
MS. ALICIA CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
11605 BRAGG AVE, LOUISVILLE, KY 40243-1353
(502) 500-7252
Mailing address
11605 BRAGG AVE, LOUISVILLE, KY 40243-1353
(502) 500-7252
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
166435
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166435
OPTICAN
KY
Enumeration date
07/25/2020
Last updated
01/22/2021
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