Individual
DUSTIN KANE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
(859) 254-3376
Mailing address
1351 NEWTOWN PIKE BLDG 1, LEXINGTON, KY 40511-1277
(859) 253-1686
(859) 254-3376
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
04/01/2025
Last updated
04/01/2025
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