Individual
VIVEK PRAKASH SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1131 FAIRVIEW AVE STE 305, BOWLING GREEN, KY 42103-1708
(270) 348-4564
Mailing address
EAST 1ST AVENUE, BOWLING GREEN, KY 42101
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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