ProviderBusinessMailingAddressFaxNumber = '2706519248'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1750462586
BLAINE
LANA
3387 BRISTOW RD
BOWLING GREEN
KY
421039519
1992821722
PROFFITT
ASHLEY
4038 OLD MUNFORDVILLE RD.
CAVE CITY
KY
42127
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