Individual
MR. STEVEN R DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
303 DANIEL BOONE DR, BARBOURVILLE, KY 40906-1105
(606) 813-0481
Mailing address
GENERAL DELIVERY, HIMA, KY 40951-9999
(606) 813-0481
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY-1989
KY
Other
Enumeration date
03/17/2011
Last updated
03/17/2011
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