Individual
BASHA FERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 S 4TH ST, LOUISVILLE, KY 40203-3205
(502) 386-0009
Mailing address
14306 BROADDUS ST APT 101, LOUISVILLE, KY 40245-2931
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/13/2020
Last updated
02/25/2020
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