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General NPI Number Information
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NPI Number | 1194279729
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Entity Type | Organization
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Legal Business Name | FRONTLINE TRAINING CENTER, LLC
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 1321 CUMBERLAND FALLS HWY SUITE 3
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City | CORBIN
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State | KY
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Zip | 40701-2720
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Country | US
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Telephone | 877-366-8890
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Fax | 788-248-6141
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Provider Business Mailing Address
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Address Line | 1321 CUMBERLAND FALLS HWY SUITE 3
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City | CORBIN
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State | KY
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Zip | 40701-2720
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Country | US
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Telephone | 877-366-8890
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Fax | 788-248-6141
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Authorized Official
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Title or Position | SITE MANANGER
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Name | MR. MIKE OSBORNE
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Credential | CCMA
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Telephone | 606-312-2436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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