NPI | 1275160376 |
---|---|
Doing Business As | TK STONE MIDDLE HEALTHY KIDS CLINIC |
Entity Type | Organization |
Authorized Contact | ERIC E LOY CEO 270-858-6655 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2020-03-26 |