| NPI | 1952088254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT WILLIAMS Director 270-765-2157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |