# UNBRIDLED HEALTHCARE SYSTEM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295461663
- **Authorized official:** TERRI TYE (BILLING AND CREDENTIALING)
- **Authorized official phone:** (606) 215-3832

## Contact information

- **Practice address:** 220 N MAIN ST, LONDON, KY 40741-1367
- **Practice address phone:** (606) 770-3014
- **Mailing address:** PO BOX 2448, LONDON, KY 40743-2448
- **Mailing address phone:** (606) 770-3014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 07/28/2022
- **Last updated:** 10/11/2023