| NPI | 1184221038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD CLAY BIBB Medical Director 859-556-7487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2020-10-20 |