Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | KY-0379 | KY |
NPI | 1174655351 |
---|---|
Provider Name | Joann Hurle |
First Address | Louisville, KY 40241-3000 |
Second Address | Louisville, KY 40241-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |