Basic Information
| Provider Information | |||||||||
| NPI: | 1356516405 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WHC MEDICAL SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 970 W WOOSTER ST | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434022643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193535081 | ||||||||
| FaxNumber: | 4193532415 | ||||||||
| Practice Location | |||||||||
| Address1: | 970 W WOOSTER ST | ||||||||
| Address2: | SUITE 130 | ||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434022643 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193535081 | ||||||||
| FaxNumber: | 4193532415 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2008 | ||||||||
| LastUpdateDate: | 04/29/2008 | ||||||||
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| AuthorizedOfficialLastName: | FROST | ||||||||
| AuthorizedOfficialFirstName: | NANCY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4193525899 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.