Individual
VIJAYA RAMA AMMISETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
11203 MAIN STREET, MARTIN, KY 41649-0910
(606) 285-6400
Mailing address
P.O. BOX 910, MARTIN, KY 41649-0910
(606) 285-6400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42400
KY
Other
Enumeration date
02/25/2009
Last updated
03/04/2010
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