| NPI | 1215205414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE NICOLE BOSLER Assistant Professor 502-413-8979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: KY 15750) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2011-12-02 |