RICHARD T.C. WAN, M.D. ,PSC
Managed Care Organizations at Roberts St, Provo, KY

License number
Kentucky 16599
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: RICHARD TC WAN MD
Title: OWNER
Phone: (270) 526-3841
Address
Address
101 W Roberts St, Provo, KY 42261
National Provider ID: 1104996776
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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