| NPI | 1467506501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T BEASLEY Owner 502-366-1479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 00126) |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-08-28 |