| NPI | 1477703619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY D. SMITH Owner 270-765-5926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: KY 38746) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007523) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2014-10-21 |