| NPI | 1699842088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI BYERS-ABSTON Owner 502-426-6715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: KY 3737) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-03-18 |