Individual
MS. KELLY EGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1124 E BRECKINRIDGE ST, LOUISVILLE, KY 40204-1856
(502) 807-5631
Mailing address
1124 E BRECKINRIDGE ST, LOUISVILLE, KY 40204-1856
(502) 807-5631
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
KY
Other
Enumeration date
05/25/2011
Last updated
05/25/2011
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