Organization
TOTAL LIFE CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L STEVENS CMOM (PRACTICE MANAGER)
(270) 554-3904
Entity
Organization
Contact information
Practice address
2850 LONE OAK RD, BAYLEY SQUARE, SUITE 4, PADUCAH, KY 42003-8043
(270) 554-3904
(270) 534-8928
Mailing address
2850 LONE OAK RD, BAYLEY SQUARE, SUITE 4, PADUCAH, KY 42003-8043
(270) 205-1394
(270) 534-8928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
KY
207R00000X
Internal Medicine Physician
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65902389
—
KY
Enumeration date
12/07/2006
Last updated
09/04/2024
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