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Organization
TOTAL FITNESS CONNECTION,PLLC
Active
Organization
TOTAL FITNESS CONNECTION,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY GLASS (CLAIMS/CREDENTIALING SPECIALIST)
(270) 781-1151
Entity
Organization
Contact information
Practice address
2235 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-5081
(270) 781-1151
Mailing address
2235 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-5081
(270) 781-1151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043205024
NPI
KY
01
—
1184620098
NPI
KY
01
—
1225034945
NPI
KY
01
—
1568421527
NPI
KY
01
—
1710983440
NPI
KY
01
—
1760488480
NPI
KY
Enumeration date
09/01/2006
Last updated
12/28/2009
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