NPI | 1326210709 |
---|---|
Entity Type | Organization |
Authorized Contact | REX A TUNGATE CEO, Administrator 270-384-4753 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3234P) |
Enumeration Date | 2008-03-26 |
Last Update Date | 2008-03-26 |