Individual
HEATHER SALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
626 HARVARD DR, ELIZABETHTOWN, KY 42701-3122
(606) 776-7347
(866) 236-1503
Mailing address
626 HARVARD DR, ELIZABETHTOWN, KY 42701-3122
(606) 776-7347
(866) 236-1503
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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