| NPI | 1144742016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG MILLER Evo CFO 502-708-4693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology |
| 208D00000X General Practice | |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-07-21 |