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General NPI Number Information
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NPI Number | 1225315591
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Entity Type | Organization
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Legal Business Name | KENTUCKY MOUNTAIN HEALTH, LLC
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 101 HIBBARD ST STE 100
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City | PIKEVILLE
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State | KY
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Zip | 41501-1788
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Country | US
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Telephone | 606-433-0404
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Fax | 606-432-0405
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Provider Business Mailing Address
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Address Line | 101 HIBBARD ST STE 100
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City | PIKEVILLE
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State | KY
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Zip | 41501-1788
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Country | US
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Telephone | 606-433-0404
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Fax | 606-432-0405
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. BRANDY M MEADOWS
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Credential | BSN
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Telephone | 606-433-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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