Organization
PERSONAL FAMILY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN WELLS (OWNER)
(859) 336-3365
Entity
Organization
Contact information
Practice address
79 BOBOLINK DR, SPRINGFIELD, KY 40069-1516
(859) 336-3365
(859) 336-1403
Mailing address
79 BOBOLINK DR, SPRINGFIELD, KY 40069-1516
(859) 336-3365
(859) 336-1403
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
21969
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50034745
PASSPORT GROUP
KY
05
—
64219694
—
KY
Enumeration date
09/14/2011
Last updated
12/22/2011
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