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Unbridled Healthcare System LLC

General Practice in London, KY. Organization (NPI-2).

NPI number1295461663
StatusActive
Last updated in NPPESOct 11, 2023

Details

NPI
1295461663
Entity type
Organization (NPI-2)
Legal business name
Unbridled Healthcare System LLC
Organization subpart
No
Enumeration date
Jul 28, 2022
Certification date
Oct 11, 2023
Last updated
Oct 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice––Yes
261Q00000X Clinic/Center––

Practice location

220 N Main St
London, KY 40741-1367

Phone 606-770-3014

Mailing address

Po Box 2448
London, KY 40743-2448

Phone 606-770-3014

Authorized official

Terri Tye
Billing And Credentialing
6062153832

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