TISA MARIE REVELS

LOUISVILLE, KY
NPI1750424859
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: KY  SA029)
Additional Taxonomies174400000X Specialist
(Licence: KY  SA029)
Enumeration Date2007-02-15
Last Update Date2016-03-03
Business Address
Mrs. TISA MARIE REVELS SA-C, KCSA
4001 KRESGE WAY SUITE 200
LOUISVILLE, KY 40207-4640
Phone number: 502-895-1995
Mailing Address
Mrs. TISA MARIE REVELS SA-C, KCSA
PO BOX 950248
LOUISVILLE, KY 40295-0248
Phone number: 502-253-1035