| NPI | 1346356284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHANA M PRESTON Billing Director 502-587-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: KY 079020) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: KY 079020) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 079020) | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-02-27 |