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General NPI Number Information
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NPI Number | 1497290878
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Entity Type | Organization
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Legal Business Name | FAST PACE KENTUCKY PLLC
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 2955 FORT CAMPBELL BLVD
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-4901
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Country | US
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Telephone | 270-632-1548
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Fax | 270-632-1572
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Provider Business Mailing Address
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Address Line | 1100 KENNEDY BRASHER RD.
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City | GREENVILLE
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State | KY
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Zip | 42345
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Country | US
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Telephone | 618-304-3825
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHRISTY LITTLEJOHN
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Credential |
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Telephone | 931-253-1110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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