| NPI | 1003364373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWIGHT HOWELL SUTTON Owner 270-780-3546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KY 40753) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-11-08 |