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66 Isaiah Lane Ste 2 Hustonville KY 40437-0259 | |
(606) 346-2795 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 66 Isaiah Lane, Hustonville, Kentucky |
Authorized Official Name and Position | Jennifer R. Pelfrey (CHIEF OFFICE OF OPERATIONS) |
Authorized Official Contact | 8595391339 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 259 66 Isaiah Drive Ste 2 Hustonville KY 40437-0259 Ph: (859) 539-1339 | 66 Isaiah Lane Ste 2 Hustonville KY 40437-0259 Ph: (606) 346-2795 |
NPI Number | 1902123870 |
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Provider Enumeration Date | 04/30/2010 |
Last Update Date | 07/26/2010 |
Identifier | Type | State | Issuer |
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1902123870 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 5466P (Kentucky) | Primary |