| NPI | 1457860033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN SOCHA Organizer 502-434-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: KY 5352) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |