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1811629900
ALEXIS LEENA STALLARD
LOUISVILLE, KY
NPI
1811629900
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-06-27
Last Update Date
2022-06-27
Business Address
ALEXIS LEENA STALLARD
901 S 4TH ST
LOUISVILLE, KY 40203-3205
Phone number: 502-585-9911
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Mailing Address
ALEXIS LEENA STALLARD
9714 BROOKS BEND RD
LOUISVILLE, KY 40258-4623
Phone number: 502-994-9783
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