Organization
LIVING FREE RECOVERY, PLLC
Active
Parent organization
HOMETOWN FAMILY CARE, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOMETOWN FAMILY CARE, PLLC
Authorized official
MARY FAIRCHILD (BILLING MANAGER)
(606) 886-0224
Entity
Organization
Contact information
Practice address
400 UNIVERSITY DR, PRESTONSBURG, KY 41653-1080
(606) 886-0224
(606) 886-9908
Mailing address
PO BOX 1810, PRESTONSBURG, KY 41653-5810
(606) 886-0224
(606) 886-9908
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02805
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
02805
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64061328
—
KY
Enumeration date
10/05/2016
Last updated
10/05/2016
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