DEREK LIST

LOUISA, KY
NPI1770136947
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2019-07-17
Last Update Date2019-07-17
Business Address
DEREK LIST
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-638-0938
Mailing Address
DEREK LIST
PO BOX 726
LOUISA, KY 41230-0726
Phone number:
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