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General NPI Number Information
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NPI Number | 1922527712
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Entity Type | Individual
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Provider Name | JULIE ANN LESTER ATC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 09/13/2017
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Provider Practice Location Address
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Address Line | 1400 GLORIA TERRELL DR
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City | WILDER
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State | KY
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Zip | 41076-9188
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Country | US
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Telephone | 859-781-2800
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Fax | 859-781-2800
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Provider Business Mailing Address
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Address Line | 9023 LICKING PIKE
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City | ALEXANDRIA
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State | KY
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Zip | 41001-9033
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Country | US
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Telephone | 859-781-2800
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000090353
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License Number State | KY
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