Individual
TOLLY B ALSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3101 PARISA DR., PADUCAH, KY 42003
(270) 444-8477
(270) 444-8479
Mailing address
3101 PARISA DR., PADUCAH, KY 42003
(270) 444-8477
(270) 444-8479
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1898
TN
Other
Enumeration date
08/15/2005
Last updated
08/22/2018
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