| NPI | 1356012165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE HAY Member/Owner 502-387-4442 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2021-10-22 |