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District 4 Cdo Program — NPI 1164559522, Bowling Green, KY | NPI Central

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NPI 1164559522

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District 4 Cdo Program

NPI 1164559522 · Supports Brokerage Agency · Bowling Green, KY

Provider details

NPI number: 1164559522
Entity type: Organization
Primary specialty: Supports Brokerage AgencyAgencies
Authorized official: Ronald Becker, Acting Executive Director

Practice location

177 Graham Ave

Bowling Green, KY 42101-9175

Phone: (270) 781-2381

Fax: (270) 842-0768

More KY providers

Mailing address

Po Box 90005

Bowling Green, KY 42102-9005

Registry dates

Enumerated: 2007-02-27
Last updated: 2020-08-22

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.