Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 000296 | KY |
NPI | 1164722831 |
---|---|
Provider Name | Brenda Clay Stoner |
First Address | Louisville, KY 40218-2863 |
Second Address | Louisville, KY 40211-1366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2010 |
Last Update Date | 28/10/2010 |