| NPI | 1114649696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HUHN Medical Director 502-909-0772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| 207X00000X Orthopaedic Surgery | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2024-07-31 |