Organization
WKVC OF BOWLING GREEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PRISCILLA E BRINKMAN LCSW (SOCIAL WORKER)
(630) 232-1946
Entity
Organization
Contact information
Practice address
1711 DESTINY LN STE 118, BOWLING GREEN, KY 42104-1066
(270) 782-8866
Mailing address
711 SOUTH ST, GENEVA, IL 60134-2511
(630) 232-1946
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
11/06/2008
Last updated
03/31/2009
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