| NPI | 1043576572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILL HANEY Owner 502-836-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2017-01-03 |