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Individual

EBONI CHAMPALE WHITLOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPT, CNA

Contact information

Practice address
131 BOXWOOD DRIVE, HOPKINSVILLE, KY 42240
(270) 498-3208
Mailing address
131 BOXWOOD DRIVE, HOPKINSVILLE, KY 42240
(270) 498-3208

Taxonomy

Speciality
Code
Description
License number
State
246R00000X
Pathology Technician
Primary
P9J9G2B9
KY

Other

Enumeration date
11/22/2021
Last updated
11/22/2021
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