| NPI | 1235645607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA WELLS Office Manager 606-439-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2018-04-18 |