| NPI | 1063502334 |
|---|---|
| Doing Business As | M.A.S.K. |
| Entity Type | Organization |
| Authorized Contact | WILLIAM C THORNBURY Owner 270-659-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA905) |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2021-05-07 |