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Organization
MEDICAL INVESTMENT TRUST
Active
Organization
MEDICAL INVESTMENT TRUST
Active
Other names
Asthma and Allergy Center
Organization subpart
No
Provider details
NPI number
Authorized official
DJIEN H SO (ADMINISTRATOR)
(606) 432-0174
Entity
Organization
Contact information
Practice address
156 ISLAND CREEK RD, PIKEVILLE, KY 41501-9340
(606) 432-0174
(606) 437-0438
Mailing address
PO BOX 2708, ASTHMA AND ALLERGY CENTER, PIKEVILLE, KY 41502-2708
(606) 432-0174
(606) 437-0438
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
17816
KY
363LF0000X
Family Nurse Practitioner
3001627
KY
Other
Enumeration date
01/31/2006
Last updated
09/13/2024
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