Organization
PREMIER 1 HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER KELLY BOWMAN (CEO)
(276) 524-1906
Entity
Organization
Contact information
Practice address
928 E 5TH ST N, BIG STONE GAP, VA 24219-2435
(276) 524-1906
(276) 524-1908
Mailing address
928 E 5TH ST N, BIG STONE GAP, VA 24219-2435
(276) 524-1906
(276) 524-1908
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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