| NPI | 1760547103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BEDARD Practice Manager 270-782-7464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: KY 20987) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2008-06-13 |