| NPI | 1598556888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA KATHLEEN BENNETT Facility Administrator 502-693-5292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-09-04 |