Organization
WEST TOWNE CLINICAL SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT MATHIS (OWNER)
(855) 426-6245
Entity
Organization
Contact information
Practice address
2755 W PARK DR STE 1, PADUCAH, KY 42001-9058
(270) 703-0894
Mailing address
2755 W PARK DR STE 1, PADUCAH, KY 42001-9058
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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