| NPI | 1689848525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN E. MOORE President/Owner 606-528-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 1033143) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 1086037) |
| 207R00000X Internal Medicine (Licence: KY 39404) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: KY 002008) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2011-07-28 |