| NPI | 1689070559 |
|---|---|
| Doing Business As | KENTUCKIANA FOOT AND ANKLE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KEITH WELLINGTON MYRICK Sole Owner 502-721-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2021-12-05 |