| NPI | 1740407667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN COLLINS Sole Proprietorship 270-782-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 19109) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2015-06-16 |