| NPI | 1194959452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE GAUZE Vice President 606-638-3131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 25469) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: 25469) |
| 261QP2300X Clinic/Center, Primary Care (Licence: KY 25469) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3007167) | |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2014-12-09 |