| NPI | 1831149608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC LEE Board Member 270-887-0224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY PENDING) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |