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General NPI Number Information
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NPI Number | 1699787176
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Entity Type | Organization
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Legal Business Name | JOSEPHINE'S FAYETTE, INC.
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 125 CODELL DR STE 104
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City | LEXINGTON
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State | KY
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Zip | 40509-1183
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Country | US
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Telephone | 859-269-6222
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Fax | 859-268-7492
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Provider Business Mailing Address
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Address Line | 125 CODELL DR STE 104
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City | LEXINGTON
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State | KY
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Zip | 40509-1183
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Country | US
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Telephone | 859-269-6222
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Fax | 859-268-7492
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. MELISSA J. ARMSTRONG
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Credential | CERTIFIED FITTER-MAS
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Telephone | 859-269-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | KY
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