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Search › Kentucky › 171M00000X

Benjamine Supernova

NPI 1770284036 · on the registry since 2023

Practice

Address
213 Midland Blvd
Shelbyville, KY 40065
Phone
(502) 647-0154
Organisation at this address
Crc Health Treatment Clinics, Llc
Crc Health Treatment Clinics, Llc 3255
Inferred from a shared address, not stated in the registry.
Clinicians at this address
33

Registry record

Primary taxonomy
171M00000X
171M00000X
Sex
Male
Record last updated
2023-03-14

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky