Individual
GLORIA TINSLEY MUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1436 S SHELBY ST, LOUISVILLE, KY 40217-1107
(502) 635-4533
Mailing address
1436 S SHELBY ST, LOUISVILLE, KY 40217-1107
(502) 635-4533
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
6923
KY
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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