| NPI | 1740526888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LLOYD COFFEY Administrator 606-549-5052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: KY 900281) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2020-11-10 |