| NPI | 1376190314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY PATEL Manager 502-608-5436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2019-08-28 |