| NPI | 1528195864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAGY CFO 606-430-3519 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 152W00000X Optometrist | |
| 2080B0002X Pediatrics Obesity Medicine | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 231H00000X Audiologist | |
| 261QS1200X Clinic/Center Sleep Disorder Diagnostic | |
| 261QU0200X Clinic/Center Urgent Care | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2024-03-05 |