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Organization

FAITH FAMILY PRACTICE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA M. DAVIS (OFFICE MANAGER)
(606) 743-1422
Entity
Organization

Contact information

Practice address
801 N. MAIN STR., WEST LIBERTY, KY 41472-1021
(606) 743-1422
(606) 743-3044
Mailing address
801 MAIN ST, WEST LIBERTY, KY 41472-1021
(606) 743-1422
(606) 743-3044

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
65905721
KY
Enumeration date
04/17/2007
Last updated
08/05/2008
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