| NPI | 1336093749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASTITY CONLEY Owner 859-940-1414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2026-02-23 |
| Last Update Date | 2026-04-03 |