| NPI | 1821368499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R BROOKS CALLIHAN President 606-473-6322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: KY 4699) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |