Organization
CLARK INFUSION GROUP LLC
Active
Other names
Clark Infusion Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KELSEY TAYLOR RUTH (OWNER)
(859) 582-1730
Entity
Organization
Contact information
Practice address
124 PROFESSIONAL AVE, WINCHESTER, KY 40391-1116
(859) 582-1730
Mailing address
136 LANA LN, WINCHESTER, KY 40391-2386
(859) 582-1730
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811344211
—
KY
Enumeration date
06/06/2024
Last updated
08/01/2024
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