NPI | 1174563407 |
---|---|
Entity Type | Organization |
Authorized Contact | RILEY D LOVE Md/Owner 270-415-3830 |
Organization Subpart ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 26073) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA121) |
363AM0700X Physician Assistant, Medical | |
363L00000X Nurse Practitioner (Licence: KY 3004455) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2014-06-12 |