| NPI | 1477187920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHANA M PRESTON Billing Director 502-587-1236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2025-02-27 |