| NPI | 1720389430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYED SHAH Physician 606-226-8466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |