Glow Therapeutic Services Of Kentucky, Llc | |
210 W 3rd St Owensboro KY 42303-4121 | |
(812) 453-8543 | |
(270) 906-1150 |
Full Name | Glow Therapeutic Services Of Kentucky, Llc |
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Speciality | Community/behavioral Health |
Location | 210 W 3rd St, Owensboro, Kentucky |
Authorized Official Name and Position | Marissa S Hubert (OUTPATIENT THERAPIST) |
Authorized Official Contact | 8124538543 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Glow Therapeutic Services Of Kentucky, Llc 210 W 3rd St Owensboro KY 42303-4121 Ph: (812) 453-8543 | Glow Therapeutic Services Of Kentucky, Llc 210 W 3rd St Owensboro KY 42303-4121 Ph: (812) 453-8543 |
NPI Number | 1306289293 |
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Provider Enumeration Date | 04/10/2013 |
Last Update Date | 10/04/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306289293 | NPI | - | NPPES |
P400019932 | Other | KY | MEDICARE |
30603013 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 3407 (Kentucky) | Primary |
251S00000X | Community/behavioral Health | 0981 (Kentucky) | Secondary |
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