| NPI | 1619565272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON CARNES LEWIS Owner/Md 502-855-3919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2021-01-08 |