Organization
PREMIERTOX 2.0 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN E KLIPP (PRESIDENT)
(270) 866-8854
Entity
Organization
Contact information
Practice address
150 W BEAR TRACK RD, CAMPBELLSVILLE, KY 42718-8709
(270) 858-3343
Mailing address
PO BOX 538512, ATLANTA, GA 30353-8512
(502) 226-3858
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
KY
Other
Enumeration date
09/08/2014
Last updated
05/08/2015
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