Organization
BUCKHORN LAKE AREA SUPPORT TEAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATRINA J BOWLING (OWNER/BUSINESS MANAGER)
(606) 216-7438
Entity
Organization
Contact information
Practice address
5053 N KY HIGHWAY 15, BONNYMAN, KY 41719-8972
(606) 487-1050
(606) 487-1051
Mailing address
5053 N KY HIGHWAY 15, BONNYMAN, KY 41719-8972
(606) 487-1050
(606) 487-1051
Taxonomy
Speciality
Code
Description
License number
State
251X00000X
Supports Brokerage Agency
Primary
—
—
Other
Enumeration date
02/06/2008
Last updated
06/12/2008
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