Organization
NEXUS LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L BERTRAM D.O. (PRESIDENT)
(270) 866-8881
Entity
Organization
Contact information
Practice address
1463 CAMPBELLSVILLE RD, COLUMBIA, KY 42728-2263
(270) 384-9934
Mailing address
92 JOE T PETTY DR, SUITE 400, RUSSELL SPRINGS, KY 42642-8544
(270) 866-8896
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100118690
—
KY
Enumeration date
01/29/2010
Last updated
10/04/2010
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