Organization
RIVER CITIES EYE CONSULTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNY S VALLANCE (BILLING COORDINATOR)
(606) 329-2243
Entity
Organization
Contact information
Practice address
2119 CARTER AVE, ASHLAND, KY 41101-7733
(606) 329-2243
(606) 324-2395
Mailing address
2119 CARTER AVE, ASHLAND, KY 41101
(606) 329-2243
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
41013
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7673570
AETNA
KY
Enumeration date
07/20/2007
Last updated
12/03/2007
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