Organization
PROFESSIONAL PARK DIAGNOSTICS PLLC
Active
Other names
Professional Park Diagnostics PLLC, , Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA T MATTINGLY (CREDENTIALING MANAGER)
(270) 852-8931
Entity
Organization
Contact information
Practice address
3346 PROFESSIONAL PARK, SUITE A, OWENSBORO, KY 42303-4551
(270) 228-0405
(270) 852-8924
Mailing address
3346 PROFESSIONAL PARK, SUITE A, OWENSBORO, KY 42303-4551
(270) 852-8931
(270) 852-8924
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
10/15/2020
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