ContractPatient Agreement • November 1st, 2020 • Kentucky
Contract Type FiledNovember 1st, 2020 JurisdictionThis is an Agreement between ACCESS MED, PLLC, a Kentucky professional corporation, located at 535 Wellington Way, Suite #330, Lexington, KY 40503 and 642 East Lexington Avenue, Danville, Kentucky, 40422 (Access Med), Jeremy Stich, MD, Phillip A. Williford, MSPAS, PA-C, and Ryan Miller, MSPAS, PA-C (Provider) in their capacity as agents of Access Med, and you, (Patient).