| NPI | 1811132525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENA LYNN STOCKER President 859-779-0148 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health (Licence: KY 900224) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2019-05-02 |