| NPI | 1184052920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA R EARLEY Owner 270-589-1292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: KY R4652) |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-11-08 |