| NPI | 1164080073 |
|---|---|
| Doing Business As | BUFFALO TRACE MEDICAL ARTS |
| Entity Type | Organization |
| Authorized Contact | REBECCA FORMAN Ar Manager 606-564-4016 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |