| NPI | 1104944784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY ANN EVANS Clinical Nurse Specialist 502-797-1904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |