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1043876170
MARY ALICE DISSELKAMP
ELIZABETHTOWN, KY
NPI
1043876170
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2019-05-14
Last Update Date
2023-11-08
Business Address
MARY ALICE DISSELKAMP PA-C
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701-5938
Phone number: 270-706-5787
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Mailing Address
MARY ALICE DISSELKAMP PA-C
2407 RING RD STE 108
ELIZABETHTOWN, KY 42701-5938
Phone number: 270-706-5787
Copy
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