| NPI | 1396166096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MULLINS Owner 859-655-8554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.14312-NP) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2013-12-23 |