PROVIDENCE MEDICAL LLC

LEXINGTON, KY
NPI1871312918
Entity TypeOrganization
Authorized ContactAMY MCKISSICK
Nurse Practitioner
803-240-2847
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2024-10-07
Last Update Date2024-10-07
Business Address
PROVIDENCE MEDICAL LLC
424 LEWIS HARGETT CIR STE 250
LEXINGTON, KY 40503-3687
Phone number: 803-240-2847
Mailing Address
PROVIDENCE MEDICAL LLC
1301 SUMMERVILLE AVE
COLUMBIA, SC 29201-1927
Phone number: 803-240-2847