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Organization
WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Active
Organization
WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL EDWARDS ATC, MA (DIRECTOR OF SPORTS MEDICINE)
(270) 745-6026
Entity
Organization
Contact information
Practice address
1605 AVENUE OF CHAMPIONS, RM 128, BOWLING GREEN, KY 42101-6412
(972) 687-1877
(972) 367-3434
Mailing address
PO BOX 819020, DALLAS, TX 75381-9020
(972) 687-1877
(972) 367-3434
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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