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General NPI Number Information
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NPI Number | 1750361861
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Entity Type | Individual
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Provider Name | JULIE M MANCHE AUD
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Gender | Female
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 105 DAVENTRY LN SUITE 100
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City | LOUISVILLE
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State | KY
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Zip | 40223-2879
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Country | US
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Telephone | 502-276-5755
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Fax |
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Provider Business Mailing Address
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Address Line | 207 WESTWOOD DR
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City | LOUISVILLE
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State | KY
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Zip | 40243-2040
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Country | US
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Telephone | 502-276-5755
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | KY0439
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License Number State | KY
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