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1871312918
PROVIDENCE MEDICAL LLC
LEXINGTON, KY
NPI
1871312918
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Entity Type
Organization
Authorized Contact
AMY MCKISSICK
Nurse Practitioner
803-240-2847
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2024-10-07
Last Update Date
2024-10-07
Business Address
PROVIDENCE MEDICAL LLC
424 LEWIS HARGETT CIR STE 250
LEXINGTON, KY 40503-3687
Phone number: 803-240-2847
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Mailing Address
PROVIDENCE MEDICAL LLC
1301 SUMMERVILLE AVE
COLUMBIA, SC 29201-1927
Phone number: 803-240-2847
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