| NPI | 1487989687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNNE SHROCK Onwer/Partner 502-314-7050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: KY 4426P) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2009-10-06 |