Supportive Med

NPI #1740077163 in Russell, Kentucky

Provider Information

NPI Number: 1740077163
Entity Type: Organization
Organization Name: Supportive Med
Primary Specialty: Family Medicine
Enumeration Date: Apr 21, 2025
Last Updated: Apr 21, 2025

Practice Location

Address: 1619 DIEDERICH BLVD STE B
City: Russell
State: Kentucky
ZIP Code: 41169-1779
Phone: (606) 324-0334

Authorized Official

Name: ROBERT LEVINE
Title: OWNER
Phone: (760) 636-8428

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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