| NPI | 1851959217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRADLEY ASHBY Vice President/Member 270-404-3411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2020-07-01 |