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Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Other names
Viper Elementary School Based Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
L.M. CAUDILL (CREDENTIALING)
(606) 633-4823
Entity
Organization
Contact information
Practice address
20 EDDINGTON LN, SUITE 161, VIPER, KY 41774-8226
(606) 633-4823
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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