Organization
VINE GROVE FAMILY MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY D. LAW SR. (PHYSICIAN AND OWNER)
(270) 877-6672
Entity
Organization
Contact information
Practice address
101 W MAIN ST, VINE GROVE, KY 40175-1302
(270) 877-6672
Mailing address
101 W MAIN ST, VINE GROVE, KY 40175-1302
(270) 877-6672
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/22/2007
Last updated
07/23/2007
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