| NPI | 1467867721 |
|---|---|
| Former Legal Business Name | DBA LOUISA MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARC A. WORKMAN Physician 606-638-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2015-06-15 |