| NPI | 1932492733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MOSS Owner 502-244-0923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-12-05 |