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Organization
BLUEGRASS VEIN CLINIC
Active
Organization
BLUEGRASS VEIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE SCHOENBAECHLER (CREDENTIALING SPECIALIST)
(502) 220-8437
Entity
Organization
Contact information
Practice address
201 PROFESSIONAL PARK DR, GLASGOW, KY 42141-3486
(270) 392-3661
(580) 297-9310
Mailing address
106 TRIGG CT, GLASGOW, KY 42141-2252
(270) 392-3661
(580) 297-9310
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
11/18/2021
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