| NPI | 1255827358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY D HANNA Owner 502-365-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: KY 00382) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2020-08-21 |