| NPI | 1609333830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSE ONYINYECHI URADU Medical Director 606-939-8486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |