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Organization

COMMONWEALTH SURGICAL SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY DIANA WILSON (OFFICE MANAGER)
(270) 782-0434
Entity
Organization

Contact information

Practice address
1945 SCOTTSVILLE RD B2 PMB137, BOWLING GREEN, KY 42104-3376
(270) 782-0434
(270) 782-0564
Mailing address
1925 SCOTTSVILLE RD B2 PMB 137, BOWLING GREEN, KY 42104-3376
(270) 782-0434
(270) 782-0564

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
SA272
KY

Other

Enumeration date
06/25/2014
Last updated
06/25/2014
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