| NPI | 1528707437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPENCER UDELL Owner/CEO 502-501-7692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2023-01-17 |