| NPI | 1104106954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SO Medical Director 859-485-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| 291U00000X Clinical Medical Laboratory | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2016-12-15 |