NPI | 1063913788 |
---|---|
Doing Business As | MOBILE HEALTH 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 |