Individual
AIRNEIDA BUMGARDNER-MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14800 FORT CAMPBELL BLVD, OAK GROVE, KY 42262-8304
(270) 640-4828
Mailing address
14800 FORT CAMPBELL BLVD, OAK GROVE, KY 42262-8304
(270) 640-4828
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
111731
KY
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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