| NPI | 1720653801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANYEL D CLAY Executive Director Of Revenue Cycle 502-253-4911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |