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1124151428
JERRY NELSON
LOUISVILLE, KY
NPI
1124151428
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 166933)
Enumeration Date
2007-03-14
Last Update Date
2016-06-24
Business Address
-- JERRY NELSON
2650 W BROADWAY
LOUISVILLE, KY 40211-1333
Phone number: 502-589-1100
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Mailing Address
-- JERRY NELSON
101 W MUHAMMAD ALI BLVD
LOUISVILLE, KY 40202-1423
Phone number: 502-589-8600
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