| NPI | 1174056261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL W STANLEY CEO 606-526-9005 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-06-28 |