Organization
NEW YOU
Active
Organization
NEW YOU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN O'CONNOR MCCLARY (OWNER)
(270) 685-2001
Entity
Organization
Contact information
Practice address
1725 E 18TH ST, OWENSBORO, KY 42303-1150
(270) 685-2001
(270) 685-2000
Mailing address
1725 E 18TH ST, OWENSBORO, KY 42303-1150
(270) 685-2001
(270) 685-2000
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000211325
ANTHEM
—
05
—
200124680
—
IN
05
—
90450305
—
KY
Enumeration date
03/01/2007
Last updated
06/23/2008
Update your record
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