| NPI | 1306166624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA TAYLOR Office Manager 502-583-6988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2015-08-27 |