Organization
WESTERN KENTUCKY UNIVERSITY SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL EDWARDS ATC, MA (DIRECTOR OF SPORTS MEDICINE)
(270) 745-6026
Entity
Organization
Contact information
Practice address
1605 AVENUE OF CHAMPIONS, RM 128, BOWLING GREEN, KY 42101-6412
(972) 687-1877
(972) 367-3434
Mailing address
PO BOX 819020, DALLAS, TX 75381-9020
(972) 687-1877
(972) 367-3434
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/18/2011
Last updated
04/18/2011
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