| NPI | 1730352972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER L. NELSON Owner 502-423-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2012-06-19 |