| NPI | 1972979540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVA A EDWARDS Owner 606-594-1769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 207Q00000X Family Medicine (Licence: KY 900342) | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2022-10-03 |