| NPI | 1841739612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER MCNALLY Regional Executive Director 270-415-7646 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: KY 107114) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |