Organization
THE CHILDRENS CLINIC, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAX GUCILATAR M.D. (OWNER)
(270) 699-2210
Entity
Organization
Contact information
Practice address
420 LORETTA ROAD, LEBANON, KY 40033
(270) 699-2210
(270) 699-4335
Mailing address
420 LORETTA ROAD, LEBANON, KY 40033
(270) 699-2210
(270) 699-4335
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
39507
KY
Other
Enumeration date
01/16/2007
Last updated
08/22/2020
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