| NPI | 1093881997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MIX Credentialing Coordinator 270-766-1990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2022-07-21 |