Individual
JACKSON TAYLOR TROMBLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1053 LOVERS LN, BOWLING GREEN, KY 42103-7166
(270) 807-0335
Mailing address
90 HOWARD DR, SHELBYVILLE, KY 40065-8138
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
T17-008-136
KY
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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