| NPI | 1538474408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE MIGLIACCIO Billing Manager 606-613-2226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-19 |