| NPI | 1841335049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIKA DENISE DALLAS President 270-444-9934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: KY 35228) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2009-03-03 |