Individual
JIM HISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9127 GALENE DR STE 4, LOUISVILLE, KY 40299-1586
(502) 896-8147
Mailing address
31218 TUCKER LAKE DRIVE, LOUISVILLE, KY 40299
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A00825
KY
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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