Individual
KELSEY RENE TRAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
147 SYCAMORE ST, PIKEVILLE, KY 41501-9118
(606) 218-1005
Mailing address
147 SYCAMORE ST, PIKEVILLE, KY 41501-9118
(606) 218-1005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046011536
IL
152W00000X
Optometrist
10249TG
TX
152W00000X
Optometrist
Primary
2309DT
KY
Other
Enumeration date
06/04/2021
Last updated
05/10/2023
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