Individual
KAITLYN DAWN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DIECKS DR, ELIZABETHTOWN, KY 42701-2443
(270) 750-7848
Mailing address
350 CLARKSON RD, VINE GROVE, KY 40175-6098
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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