| NPI | 1114689361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE HAY Owner/Member 502-387-4442 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-10-05 |
| Last Update Date | 2021-10-22 |