Individual
LARRY B ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2317 CUMBERLAND AVE, MIDDLESBORO, KY 40965-2834
(606) 242-3100
(606) 242-3984
Mailing address
2317 CUMBERLAND AVE, MIDDLESBORO, KY 40965-2834
(606) 242-3100
(606) 242-3984
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3005024
KY
363LF0000X
Family Nurse Practitioner
Primary
3005024
KY
Other
Enumeration date
03/12/2007
Last updated
06/10/2024
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