| NPI | 1063650471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY B FOUCH Owner 859-498-5243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 39940) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 5332P) | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2020-10-14 |