| NPI | 1063913788 |
|---|---|
| Doing Business As | MOBILE HEALTH CLINIC |
| Doing Business As | MIDDLESBORO CAMPUS CLINIC |
| Entity Type | Organization |
| Authorized Contact | DELENA P MILLER Credentialing 606-633-4823 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: KY 700017) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2024-03-06 |