| NPI | 1982700027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY LEE SMITH Owner 606-526-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: KY SA-111) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2013-09-09 |