MAHOGHANY TREE ROOTED RESOURCES

LOUISVILLE, KY
NPI1508645201
Entity TypeOrganization
Authorized ContactNASIRA MAH-JABEEN
Credentialing Agent
502-579-0170
Organization Subpart ?No
Primary Taxonomy261QM1300X Clinic/Center, Multi-Specialty
Enumeration Date2023-09-22
Last Update Date2023-09-22
Business Address
MAHOGHANY TREE ROOTED RESOURCES
4059 LA SALLE AVE
LOUISVILLE, KY 40215-1321
Phone number: 502-579-0170
Mailing Address
MAHOGHANY TREE ROOTED RESOURCES
642 CECIL AVE
LOUISVILLE, KY 40211-3162
Phone number: