| NPI | 1164619219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L FREEMAN Owner 606-523-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 2597p) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |