NPI | 1871757930 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN T HACKBARTH Secretary 270-417-4813 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KY 740041) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2008-07-17 |
Last Update Date | 2014-01-30 |