MIRANDA MALLICOAT

LOUISVILLE, KY
NPI1487309290
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: KY  TSA026)
Additional Taxonomies208600000X Surgery
(Licence: KY  TSA026)
Enumeration Date2022-02-21
Last Update Date2022-03-09
Business Address
MIRANDA MALLICOAT
3900 KRESGE WAY STE 51
LOUISVILLE, KY 40207-4683
Phone number: 502-259-5955
Mailing Address
MIRANDA MALLICOAT
5200 COMMERCE CROSSINGS DR FL 3
LOUISVILLE, KY 40229-2182
Phone number: 502-253-4924