| NPI | 1932649605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY ROARL President/Owner 606-242-3100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3011074) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |