| NPI | 1184228553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE GAYLE PHELPS Owner 606-280-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-11-25 |
| Last Update Date | 2022-06-24 |