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General NPI Number Information
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NPI Number | 1245686245
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Entity Type | Organization
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Legal Business Name | PAINTSVILLE PRIMARY CARE AND SPA
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 636 JEFFERSON AVE
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City | PAINTSVILLE
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State | KY
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Zip | 41240-1349
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Country | US
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Telephone | 606-788-1035
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Fax | 606-788-1458
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Provider Business Mailing Address
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Address Line | 636 JEFFERSON AVE
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City | PAINTSVILLE
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State | KY
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Zip | 41240-1349
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Country | US
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Telephone | 606-788-1035
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Fax | 606-788-1458
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Authorized Official
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Title or Position | OWNER/ OFFIC MGR
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Name | MR. STEPHEN J ARNETT
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Credential |
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Telephone | 606-788-1035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | KY
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