Individual
MR. EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4227 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1527
(502) 451-5959
Mailing address
2126 VILLAGE DR APT 4, LOUISVILLE, KY 40205-1940
(832) 868-8429
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
161913
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161913
MASSAGE LIC
KY
Enumeration date
01/26/2021
Last updated
01/26/2021
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