| Organization Name: | KENTUCKY BREAST CARE |
| NPI Number: | 1295097319 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANDREA WOODROOF (MANAGING MEMBER) |
| Mailing Address: | 38 Joe T Petty Drive Russell Springs |
| State: | KY US |
| Postal Code: | 426428553 |
| Phone Number: | 6066589535 |
| Fax Number: | 2708669716 |
| NPI Enumeration Date: | 06/14/2012 |
| NPI Last Update Date: | 11/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |