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Organization

TOTAL FITNESS CONNECTION,PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY GLASS (CLAIMS/CREDENTIALING SPECIALIST)
(270) 781-1151
Entity
Organization

Contact information

Practice address
2235 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-5081
(270) 781-1151
Mailing address
2235 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-5081
(270) 781-1151

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043205024
NPI
KY
01
1184620098
NPI
KY
01
1225034945
NPI
KY
01
1568421527
NPI
KY
01
1710983440
NPI
KY
01
1760488480
NPI
KY
Enumeration date
09/01/2006
Last updated
12/28/2009
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