| NPI | 1760822969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVONNA GILES DURHAM Nurse Practitioner 606-526-9664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KY 3003233) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2013-07-02 |