Individual
MS. LISA ANN MAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
348 S HIGHWAY 1223, CORBIN, KY 40701-4643
(606) 521-7045
Mailing address
348 S HIGHWAY 1223, CORBIN, KY 40701-4643
(606) 521-7045
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M94719254
KY
Other
Enumeration date
05/29/2014
Last updated
08/29/2016
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