| NPI | 1073079273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DANIELS Owner/Physician 606-432-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2021-10-11 |