| NPI | 1194521005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CARROLL CORDER Owner 606-677-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-02-21 |