| NPI | 1487112843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS WHEALTON Owner 606-280-7875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2023-02-21 |