| Organization Name: | RIVERVIEW FAMILY PRACTICE PSC |
| NPI Number: | 1144218413 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK B KINGSTON (CLINIC DIRECTOR) |
| Mailing Address: | 203 S Water St Louisa |
| State: | KY US |
| Postal Code: | 412301387 |
| Phone Number: | 6066384504 |
| Fax Number: | 6066384186 |
| NPI Enumeration Date: | 10/11/2005 |
| NPI Last Update Date: | 11/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |