Most Relevant Information
Provider Data
| NPI Number: | 1003522707 |
| Provider Name: | ABIGAIL LEE STAFFORD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/25/2023 |
| Last Updated: | 01/25/2023 |
Provider Practice Location
2203 IRON LOOP PATH
GEORGETOWN
KY
403248108
Practice Location Phone/Fax
| Phone: | 6064229887 |
| Fax: |
Provider Mailing Location
2203 IRON LOOP PATH
GEORGETOWN
KY
403248108
Provider Mailing Phone/Fax
| Phone: | 6064229887 |
| Fax: |