| NPI | 1619258498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SMITH RICE Co Owner 270-274-0638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3003830) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY 13394) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2011-09-07 |