Most Relevant Information
Provider Data
| NPI Number: | 1003642596 |
| Provider Name: | LEAH GRACE SUTTLES |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/11/2024 |
| Last Updated: | 09/11/2024 |
Provider Practice Location
7693 STATE HIGHWAY 773
DENTON
KY
411328913
Practice Location Phone/Fax
| Phone: | 3047331094 |
| Fax: |
Provider Mailing Location
7693 STATE HIGHWAY 773
DENTON
KY
411328913
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |