Organization
CPCFS/ROBERT FANE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT BRUCE FANE PH.D (OWNER)
(270) 393-9833
Entity
Organization
Contact information
Practice address
1011 LEHMAN AVE, SUITE 103, BOWLING GREEN, KY 42103-6515
(270) 393-9833
(270) 393-9835
Mailing address
1011 LEHMAN AVE, SUITE 103, BOWLING GREEN, KY 42103-6515
(270) 393-9833
(270) 393-9835
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/02/2012
Last updated
02/02/2012
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