| NPI | 1205137494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY CONNETT Director Of Finance 606-833-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2019-05-20 |