| NPI | 1992258305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJIV GUPTA Physician 606-474-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: KY TC494) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |