| NPI | 1356625677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D BARNETT President 606-248-7505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: KY 6553) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: KY 6553) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2011-10-05 |