# COMMONWEALTH BIOMEDICAL RESEARCH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMONWEALTH BIOMEDICAL RESEARCH
- **Other names:** Crofton Family Medical Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790920825
- **Legal business name:** COMMONWEALTH BIOMEDICAL RESEARCH
- **Authorized official:** BRET A. WITTMER D.V.M. / M.D. (OWNER)
- **Authorized official phone:** (270) 825-8345

## Contact information

- **Practice address:** 136 E PRINCETON ST, CROFTON, KY 42217-8018
- **Practice address phone:** (270) 424-8885
- **Practice address fax:** (270) 424-5193
- **Mailing address:** 240 E AYR PKY, MADISONVILLE, KY 42431-8999
- **Mailing address phone:** (270) 825-8345
- **Mailing address fax:** (270) 825-2975

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | — |
| 171100000X | Acupuncturist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 12/03/2008
- **Last updated:** 08/12/2009