| NPI | 1811956089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE MAXEY General Practitioner 606-878-9611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 35548) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2013-02-01 |