Individual
LEE CAROL THREATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1169 EASTERN PKWY, LOUISVILLE, KY 40217-1417
(502) 813-8280
(502) 473-1334
Mailing address
602 RUGGLES PL, LOUISVILLE, KY 40208-2294
(270) 331-5093
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/01/2022
Last updated
03/01/2022
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