| NPI | 1629240759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REX A TUNGATE CEO, Administrator 270-384-4753 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 1854P) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2008-03-28 |