Provider Demographics
NPI:1669256913
Name:FAST PACE KENTUCKY PLLC
Entity type:Organization
Organization Name:FAST PACE KENTUCKY PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLEJOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-253-1110
Mailing Address - Street 1:PO BOX 306505
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6505
Mailing Address - Country:US
Mailing Address - Phone:931-253-1110
Mailing Address - Fax:931-722-9919
Practice Address - Street 1:521 E. CUMBERLAND GAP PKWY.
Practice Address - Street 2:SUITE 1
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2050
Practice Address - Country:US
Practice Address - Phone:606-261-2054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-18
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health