| NPI | 1386163822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY TAYLOR Owner 276-244-1557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2025-07-02 |