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General NPI Number Information
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NPI Number | 1427041037
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Entity Type | Individual
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Provider Name | JOYCE C PECK
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Gender | Female
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 1937 OLD MAIN ST SUITE 2
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City | MAYSVILLE
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State | KY
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Zip | 41056-8956
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Country | US
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Telephone | 606-759-7311
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Fax | 606-759-0610
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Provider Business Mailing Address
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Address Line | PO BOX 54
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City | WASHINGTON
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State | KY
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Zip | 41096-0054
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Country | US
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Telephone | 606-564-8794
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Fax | 606-759-0610
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 111468
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License Number State | KY
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