| NPI | 1821133141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CALVIN JOHNSON President 859-278-8421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 02349) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2013-10-02 |