| NPI | 1548711070 |
|---|---|
| Doing Business As | KINGS DAUGHTERS - CHARLES RUSSELL ELEMENTARY |
| Entity Type | Organization |
| Authorized Contact | SARA MARKS CEO/President 606-408-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-06-16 |