| NPI | 1730925686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA GUY Chief Operating Officer 502-208-8541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-10-04 |