| NPI | 1164460812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY B BOROS Business Office Manager 859-514-0251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |