Individual
LOUISSAINT LOUIS XVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2020 NEWBURG RD, LOUISVILLE, KY 40205-1803
(502) 451-3330
Mailing address
1607 HERR LN, LOUISVILLE, KY 40222-6543
(859) 797-0675
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4650
GA
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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