Organization
DANVILLE MEDICAL SPECIALTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM GOOCH APRN (OWNER)
(859) 319-8487
Entity
Organization
Contact information
Practice address
504 TENIKAT ST, DANVILLE, KY 40422-1751
(859) 319-8487
Mailing address
PO BOX 23794, BELFAST, ME 04915-4488
(859) 319-8487
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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