Individual
JACQUELINE FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
499 INDIAN MOUND DR, MT STERLING, KY 40353-1096
(859) 497-9382
Mailing address
499 INDIAN MOUND DR, MT STERLING, KY 40353-1096
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
08/01/2022
Last updated
08/01/2022
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