| Western Kentucky University Sports Medicine | |
|
1605 Avenue Of Champions Rm 128 Bowling Green KY 42101-6412 | |
| (972) 687-1877 | |
| (972) 367-3434 |
| Full Name | Western Kentucky University Sports Medicine |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 1605 Avenue Of Champions, Bowling Green, Kentucky |
| Authorized Official Name and Position | Bill Edwards (DIRECTOR OF SPORTS MEDICINE) |
| Authorized Official Contact | 2707456026 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Kentucky University Sports Medicine Po Box 819020 Dallas TX 75381-9020 Ph: (972) 687-1877 | Western Kentucky University Sports Medicine 1605 Avenue Of Champions Rm 128 Bowling Green KY 42101-6412 Ph: (972) 687-1877 |
| NPI Number | 1790075273 |
|---|---|
| Provider Enumeration Date | 04/18/2011 |
| Last Update Date | 04/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790075273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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