| NPI | 1063617173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELLAIAPPAN SOMASUNDARAM Owner 606-237-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: KY 35436) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 35436) |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3567P) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2010-04-29 |