| NPI | 1326404336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L BARRESI Owner 502-593-0083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |