Organization
LOG MOUNTAIN FAMILY HEALTHCARE LLC
Active
Parent organization
LOG MOUNTAIN FAMILY HEALTHCARE LLC
Other names
LOG MOUNTAIN CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LOG MOUNTAIN FAMILY HEALTHCARE LLC
Authorized official
TIFFENY JEAN TREECE (OWNER)
(606) 337-8887
Entity
Organization
Contact information
Practice address
101 MOUNTAIN VIEW CMNS, PINEVILLE, KY 40977-8708
(606) 337-8887
Mailing address
PO BOX 13, PINEVILLE, KY 40977-0013
(606) 337-8887
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TBD
—
KY
Enumeration date
10/26/2017
Last updated
06/16/2018
About Stedi
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