| NPI | 1861731168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T HACKBARTH Secretary 270-417-4813 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 300176) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2016-02-15 |