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1295347219
MIKEAL FANNIN
PRESTONSBURG, KY
NPI
1295347219
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2020-08-20
Last Update Date
2020-08-20
Business Address
MIKEAL FANNIN
104 S FRONT AVE
PRESTONSBURG, KY 41653-1614
Phone number: 606-886-8572
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Mailing Address
MIKEAL FANNIN
104 S FRONT AVE
PRESTONSBURG, KY 41653-1614
Phone number: 606-886-8572
Copy
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