Provider First Line Business Practice Location Address:
1906 COLLEGE HEIGHTS BOLV #11036
Provider Second Line Business Practice Location Address:
WKU SCHOOL OF NURSING ACADEMIC COMPLEX ROOM 113 D
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42101-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-745-3590
Provider Business Practice Location Address Fax Number:
270-745-3392
Provider Enumeration Date:
03/08/2006