| NPI | 1508174616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E NEIL Physician 859-278-6345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KY 26109) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-12-02 |