| NPI | 1740586213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE SMITH Director 502-238-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2015-08-05 |