Individual
SUZANN FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4192 WILDERNESS RD, MT. VERNON, KY 40456
(606) 256-3923
(606) 256-5622
Mailing address
PO BOX 1390, CORBIN, KY 40702-1390
(606) 523-5732
(606) 523-5727
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33001033
—
KY
Enumeration date
05/11/2007
Last updated
07/09/2007
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