| NPI | 1962810986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIE DENISE SMITH Owner 606-273-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KY 3004931) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2015-08-17 |