| NPI | 1548623846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK HARRELL Medical Director 502-203-4170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: KY 18577) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |