| NPI | 1144978594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGETTE LEE GREENE Managing Member 606-775-0515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2023-06-10 |