Organization
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Active
Other names
Viper Elementary School Based Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
L.M. CAUDILL (CREDENTIALING)
(606) 633-4823
Entity
Organization
Contact information
Practice address
20 EDDINGTON LN, SUITE 161, VIPER, KY 41774-8226
(606) 633-4823
Mailing address
PO BOX 40, WHITESBURG, KY 41858-0040
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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