| NPI | 1710377056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA BYRD Fnp C 270-627-3397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: TN 17056) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |