| NPI | 1902826217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA G JEFFRIES Office Manager 270-763-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 37348) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-12-13 |