| NPI | 1285930461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIJUANA K BARBRA-FOWLER Cpc, Insurance COO Rdinator 270-442-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 300083) |
| Enumeration Date | 2011-02-04 |
| Last Update Date | 2011-02-04 |