| NPI | 1336790302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTANY ADAMS Manager 606-309-6612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QP2300X Clinic/Center, Primary Care | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2019-10-02 |