Individual
JONATHAN N STACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 DANIEL BOONE PLZ, HAZARD, KY 41701-5335
(606) 487-0244
(606) 487-0279
Mailing address
120 DANIEL BOONE PLZ, HAZARD, KY 41701-5335
(606) 487-0244
(606) 487-0279
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
275909
KY
Other
Enumeration date
06/10/2022
Last updated
06/10/2022
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