Organization
WOMEN AND CHILDREN'S CLINIC, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORLANDO BRAVO (PRESIDENT)
(270) 651-9755
Entity
Organization
Contact information
Practice address
1411 N RACE ST, GLASGOW, KY 42141-3474
(270) 651-9755
Mailing address
1411 N RACE ST, GLASGOW, KY 42141-3474
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65929242
—
KY
05
—
78903911
—
KY
Enumeration date
03/05/2007
Last updated
12/19/2007
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