| NPI | 1215061940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBBECA J SUTTON Owner 502-479-3245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: KY 34205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 34205) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: KY 34205) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-11-16 |