| NPI | 1356521223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA LYNN MCDANIELS Operating Manager / Owner 859-626-0627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 34004) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |