# MEDICAL INVESTMENT TRUST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Asthma and Allergy Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053382788
- **Authorized official:** DJIEN H SO (ADMINISTRATOR)
- **Authorized official phone:** (606) 432-0174

## Contact information

- **Practice address:** 156 ISLAND CREEK RD, PIKEVILLE, KY 41501-9340
- **Practice address phone:** (606) 432-0174
- **Practice address fax:** (606) 437-0438
- **Mailing address:** PO BOX 2708, ASTHMA AND ALLERGY CENTER, PIKEVILLE, KY 41502-2708
- **Mailing address phone:** (606) 432-0174
- **Mailing address fax:** (606) 437-0438

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207K00000X | Allergy & Immunology Physician | 17816 | KY | Yes |
| 363LF0000X | Family Nurse Practitioner | 3001627 | KY | — |

## Other

- **Enumeration date:** 01/31/2006
- **Last updated:** 09/13/2024