AUTUMN VICTORIA JUSTICE

SOMERSET, KY
NPI1841872801
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: KY  05621)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-04-28
Last Update Date2024-07-10
Business Address
AUTUMN VICTORIA JUSTICE DO
305 LANGDON ST
SOMERSET, KY 42503-2750
Phone number: 606-679-7441
Mailing Address
AUTUMN VICTORIA JUSTICE DO
124 C MCKINLEY RD
JAMESTOWN, KY 42629
Phone number: 270-566-2453