Organization
FIBRO CARE CLINIC, LLC
Active
Other names
Birk Grove Life Centre
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ROMMELMAN (BUSINESS MANAGER)
(270) 415-9575
Entity
Organization
Contact information
Practice address
5150 VILLAGE SQUARE DR, PADUCAH, KY 42001-9060
(270) 415-9575
Mailing address
PO BOX 7208, PADUCAH, KY 42002-7208
(270) 415-9575
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
1672
KY
225100000X
Physical Therapist
003235
KY
363L00000X
Nurse Practitioner
Primary
4806P
KY
Other
Enumeration date
07/31/2008
Last updated
11/11/2008
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