BEN W BACK

HAZARD, KY
NPI1619942562
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: KY  PA364)
Enumeration Date2006-02-22
Last Update Date2021-05-13
Business Address
BEN W BACK PA
210 BLACK GOLD BLVD STE 106
HAZARD, KY 41701-2620
Phone number: 606-436-0711
Mailing Address
BEN W BACK PA
PO BOX 959
HAZARD, KY 41702-0959
Phone number: 606-589-5514
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