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General NPI Number Information
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NPI Number | 1295986297
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CARE ASSOCIATES OF CORBIN
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 2801 US HIGHWAY 25 E SUITE 98
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City | MIDDLESBORO
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State | KY
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Zip | 40965-2069
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Country | US
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Telephone | 606-248-8284
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1535
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City | BARBOURVILLE
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State | KY
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Zip | 40906
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Country | US
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Telephone | 606-546-7777
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Fax |
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Authorized Official
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Title or Position | CLINIC OWNER
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Name | MS. GINA LYNN GOOD
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Credential | ARNP
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Telephone | 606-248-8284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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