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General NPI Number Information
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NPI Number | 1326103821
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Entity Type | Organization
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Legal Business Name | ALL FAMILY HEALTHCARE
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 156 N LAKE DR
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City | PRESTONSBURG
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State | KY
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Zip | 41653-1270
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Country | US
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Telephone | 606-886-3996
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Fax | 606-886-3667
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | AUXIER
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State | KY
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Zip | 41602-0103
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Country | US
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Telephone | 606-886-3996
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Fax | 606-886-3667
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBRA HOLIDAY
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Credential |
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Telephone | 606-886-3996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25775
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License Number State | KY
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