| NPI | 1336563543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CURTIS FRAZINE Sole Member 270-994-2625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2022-12-29 |