Individual
GARY JOHN VITALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D., NBC
Contact information
Practice address
290 LEXINGTON ST, VERSAILLES, KY 40383-1240
(859) 873-5656
Mailing address
290 LEXINGTON ST, VERSAILLES, KY 40383-1240
(859) 873-5656
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
141393
KY
237700000X
Hearing Instrument Specialist
Primary
100738
KY
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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