| NPI | 1376788133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY V BASTECKI Owner 859-266-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: KY 3946) |
| Enumeration Date | 2008-12-09 |
| Last Update Date | 2008-12-09 |