| NPI | 1023300191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH BURGER Network Administrator 270-782-7800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2015-01-21 |