ProviderBusinessMailingAddressFaxNumber = '2704154691'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1912976085
CARTER
RUSSELL
W
2605 KENTUCKY AVE
PADUCAH
KY
420033800
1780652347
SHIBEN
TIMOTHY
E
2605 KENTUCKY AVE
PADUCAH
KY
420033800
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