JIMMIE TANTILLO PHELPS

RICHMOND, KY
NPI1740440742
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy156FX1800X Technician/Technologist, Optician
(Licence: KY  325)
Enumeration Date2008-06-12
Last Update Date2008-06-12
Business Address
Mr. JIMMIE TANTILLO PHELPS PSC
205 GERI LN
RICHMOND, KY 40475-2359
Phone number: 859-623-4267
Mailing Address
Mr. JIMMIE TANTILLO PHELPS PSC
205 GERI LN
RICHMOND, KY 40475-2359
Phone number: 859-623-4267