NPI | 1780837062 |
---|---|
Entity Type | Organization |
Authorized Contact | PAUL K KRESTIK Physician/Owner 606-862-9900 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 5140P) |
Enumeration Date | 2008-10-30 |
Last Update Date | 2008-10-30 |