Organization
RIVERVIEW FAMILY PRACTICE PSC
Active
Organization
RIVERVIEW FAMILY PRACTICE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK B KINGSTON MD (CLINIC DIRECTOR)
(606) 638-4504
Entity
Organization
Contact information
Practice address
203 S WATER ST, LOUISA, KY 41230-1387
(606) 638-4504
(606) 638-4186
Mailing address
203 S WATER ST, PO BOX 120, LOUISA, KY 41230-1387
(606) 638-4504
(606) 638-4186
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2005
Last updated
11/11/2009
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