Individual
MARY CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
KCSA
Contact information
Practice address
1301 N RACE ST, GLASGOW, KY 42141-3454
(270) 651-4444
Mailing address
1301 N RACE ST, GLASGOW, KY 42141-3454
(270) 651-4444
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA356
KY
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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