Provider Demographics
NPI:1528191236
Name:FUESTON, ROBERT (LAC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:FUESTON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 SOUTHLAND DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1946
Mailing Address - Country:US
Mailing Address - Phone:859-595-2164
Mailing Address - Fax:855-237-3143
Practice Address - Street 1:274 SOUTHLAND DR STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1946
Practice Address - Country:US
Practice Address - Phone:859-595-2164
Practice Address - Fax:855-237-3143
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAC006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist