| NPI | 1619414604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET R WARREN Clinic Administrator 502-225-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: KY 740253) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |