Individual
STEPHANIE E SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1301 HERR LN, LOUISVILLE, KY 40222-4388
(502) 240-8804
Mailing address
9909 WHIPPS MILL RD, LOUISVILLE, KY 40223-1107
(502) 240-8804
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY-4996
KY
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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