| NPI | 1134761653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT THOMPSON Owner/Md 502-551-8305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2021-03-15 |