| NPI | 1912054388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ERTEL Owner 606-663-2511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: KY 35650) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 35650) |
| 208000000X Pediatrics (Licence: KY 35650) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2014-08-20 |