Individual
AVERY O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 S 3RD ST, LOUISVILLE, KY 40203-2215
(502) 555-6111
Mailing address
3601 DALE HOLLOW DR, HOPKINSVILLE, KY 42240-5313
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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