| NPI | 1356021059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M MCMASTERS Chairperson 502-583-8303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2024-04-15 |