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Organization

GRANT COUNTY WELLNESS CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ERNEST WILLIAM SINGLETON (R.N./C.O.O.)
(859) 325-5655
Entity
Organization

Contact information

Practice address
99 S. MAIN ST., DRY RIDGE, KY 41035
(859) 325-5655
(859) 823-0530
Mailing address
99 S. MAIN ST., DRY RIDGE, KY 41035
(859) 325-5655
(859) 823-0530

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
26944
261QP3300X
Pain Clinic/Center
Primary
0788501.06
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
208VP0000X
TAXONOMY
KY
Enumeration date
04/25/2011
Last updated
09/14/2011
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