Organization
WELLNESS CENTER OF ELKHORN CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN RAY MAYNARD PAC (OWNER)
(606) 754-3131
Entity
Organization
Contact information
Practice address
17401 HWY 80E, ELKHORN CITY, KY 41522
(606) 754-3131
(606) 754-4554
Mailing address
PO BOX 1412, ELKHORN CITY, KY 41522-1412
(606) 754-3131
(606) 754-4554
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
KY
Other
Enumeration date
11/15/2011
Last updated
01/24/2012
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