| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| 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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