Organization
LOG MOUNTAIN FAMILY HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFENY JEAN TREECE ARNP (OWNER)
(606) 337-8887
Entity
Organization
Contact information
Practice address
101 MOUNTAIN VIEW CMNS, PINEVILLE, KY 40977-8708
(606) 337-8887
(606) 337-8839
Mailing address
PO BOX 13, PINEVILLE, KY 40977-0013
(606) 337-8887
(606) 337-8839
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3004305
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78016086
—
KY
Enumeration date
07/09/2006
Last updated
04/23/2014
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