| NPI | 1720743917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN YOUNG Md 502-855-7200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |