Organization
KENTUCKY PAIN MANAGEMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY MULLINS (CEO)
(606) 476-9842
Entity
Organization
Contact information
Practice address
15 MONTGOMERY CREEK RD, VICCO, KY 41773
(606) 476-9842
Mailing address
PO BOX 129, VICCO, KY 41773-0129
(606) 476-9842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
08/22/2020
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