| NPI | 1740211663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY TERRELL CFO 859-278-1316 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 0246146) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 0246146) |
| 225100000X Physical Therapist (Licence: KY 0246146) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: KY 6547680001) | |
| 363AM0700X Physician Assistant, Medical (Licence: KY 0246146) | |
| 363L00000X Nurse Practitioner (Licence: KY 0246146) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-07-26 |