SearchKentucky104100000X

Kevin Fackler, TSW

NPI 1275242869 · on the registry since 2022

Practice

Address
4922 Lagoona Dr
Louisville, KY 40219
Phone
(502) 396-2358

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2023-09-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky