| NPI | 1114515764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN MARIE REIS Executive Officer/Manager 859-301-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2022-08-26 |