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Individual

DR. KATHY J VANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
120 W MARKET ST, LOUISVILLE, KY 40202-1332
(502) 585-2020
(502) 585-1797
Mailing address
120 W MARKET ST, LOUISVILLE, KY 40202-1332
(502) 585-2020
(502) 585-1797

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1051DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410036412
RAILROAD MEDICARE
KY
05
77010510
KY
Enumeration date
05/30/2006
Last updated
05/14/2008
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