Provider Demographics
NPI:1851618607
Name:INDUSTRIAL WELLNESS SERVICES OF KENTUCKY, PLLC
Entity Type:Organization
Organization Name:INDUSTRIAL WELLNESS SERVICES OF KENTUCKY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:606-376-9355
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-0041
Mailing Address - Country:US
Mailing Address - Phone:606-376-9355
Mailing Address - Fax:606-376-9356
Practice Address - Street 1:1570 N HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653-4230
Practice Address - Country:US
Practice Address - Phone:606-376-9355
Practice Address - Fax:606-376-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health