Organization
EASTERN KENTUCKY RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY S FRYMAN RN (OWNER/ADMIN)
(859) 569-3145
Entity
Organization
Contact information
Practice address
475 SHOPPERS DR, WINCHESTER, KY 40391-1380
(859) 355-5010
(859) 355-5121
Mailing address
1094 US HIGHWAY 27 S STE A, CYNTHIANA, KY 41031-7078
(859) 569-3145
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
KY
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810848
AODE LICENSE
KY
Enumeration date
06/21/2018
Last updated
02/06/2023
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