| NPI | 1063889582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL B BAYLESS Owner 606-248-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 16500) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2020-02-25 |