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Individual

MR. JEFF BIDWELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
KCSA

Contact information

Practice address
909 S CARROLLTON ST, CENTRAL CITY, KY 42330-5853
(270) 754-3022
Mailing address
909 S CARROLLTON ST, CENTRAL CITY, KY 42330-5853
(270) 754-3022

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
KCSA
KY

Other

Enumeration date
01/05/2006
Last updated
07/08/2007
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