NPI | 1518638329 |
---|---|
Entity Type | Organization |
Authorized Contact | DWAYNE HAY Member/Owner 502-387-4442 |
Organization Subpart ? | Yes |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-09-22 |
Last Update Date | 2021-10-22 |