| NPI | 1831448679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T CECIL Sole Member 270-575-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363A00000X Physician Assistant (Licence: KY PA403) | |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2016-12-20 |