| NPI | 1275041006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE G O'CONNELL Member 859-294-0130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 208D00000X General Practice (Licence: KY 31089) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2018-01-15 |