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General NPI Number Information
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NPI Number | 1306011614
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Entity Type | Organization
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Legal Business Name | GERALD V HONCHELL
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 153 PATCHEN DR 59-61
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City | LEXINGTON
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State | KY
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Zip | 40517
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Country | US
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Telephone | 859-269-5653
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Fax | 859-269-5753
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Provider Business Mailing Address
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Address Line | 153 PATCHEN DR 59-61
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City | LEXINGTON
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State | KY
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Zip | 40517-4420
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Country | US
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Telephone | 859-269-5653
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Fax | 859-269-5753
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Authorized Official
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Title or Position | OWNER JEROME BEAUTIY BOUTIQUE
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Name | MR. GERALD V HONCHELL
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Credential |
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Telephone | 859-269-5653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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