| NPI | 1376692657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP R MULLINS CEO 606-487-0776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: KY 29445) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2015-08-15 |