| NPI | 1356499602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL C. ALLEN CEO 859-977-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: KY 39043) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2011-01-28 |