Individual
JILLIAN ALLISON TESLOW RICKERTSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
734 W MAIN ST STE 100, LOUISVILLE, KY 40202-3687
(502) 804-4811
Mailing address
427 US 31W BYP STE 202, BOWLING GREEN, KY 42101-1703
(270) 796-6160
(270) 904-5774
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
263056
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2017
Last updated
06/04/2020
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