Penny Medicinebear

NPI #1487972287 in Smiths Grove, Kentucky

Provider Information

NPI Number: 1487972287
Entity Type: Organization
Organization Name: Penny Medicinebear
Primary Specialty: Taxi
Enumeration Date: May 4, 2010
Last Updated: May 4, 2010

Practice Location

Address: 324 SUNSET AVE
City: Smiths Grove
State: Kentucky
ZIP Code: 42171-8164
Phone: (270) 784-7079

Authorized Official

Name: MR. MICHAEL FUQUA MEDICINEBEAR, N/A
Title: CO-OWNER
Phone: (270) 784-7079

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Taxi	344600000X	Primary

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