| NPI | 1518478783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RUSH Sole Member 502-742-9392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2024-08-13 |