| NPI | 1043414873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE E JACOB President 502-895-1489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |