| NPI | 1174773188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T HOUSTON Owner 270-926-8828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: KY 21411) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: KY 40582) |
| 173000000X Legal Medicine (Licence: KY 42304) | |
| 363AM0700X Physician Assistant, Medical (Licence: KY PA787) | |
| 363L00000X Nurse Practitioner (Licence: KY 3007096) | |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2012-05-24 |