Organization · Type 2 NPI
Avante Garde Health Centers, LLC
Primary Care Clinic/Center · Russell Springs, KY
NPI number
1407125016
Active
Practice location
72 Joe T Pettey Dr, Suite B
Russell Springs, KY 42642
Fax (270) 858-4957
Mailing address
PO Box 1383
Russell Springs, KY 42642-1383
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
About NPI 1407125016
Avante Garde Health Centers, LLC's National Provider Identifier is 1407125016, issued on Dec 28, 2011. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Russell Springs, KY. The record was last updated on Dec 28, 2011.