Icc Medical LLC

NPI #1376730705 in Glasgow, Kentucky

Provider Information

NPI Number
1376730705
Entity Type
Organization
Organization Name
Icc Medical LLC
Primary Specialty
Nurse Practitioner - Family
Enumeration Date
Oct 1, 2007
Last Updated
Oct 1, 2007

Practice Location

Address
405 S L ROGERS WELLS BLVD
ZIP Code
42141-1725
Phone
(270) 834-8892

Authorized Official

Name
DR. ROGER WILLIAMS, MD
Title
OWNER
Phone
(270) 834-8892

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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