NPI | 1750635926 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT R SO Medical Director 859-344-7900 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 363L00000X Nurse Practitioner |
363A00000X Physician Assistant | |
291U00000X Clinical Medical Laboratory | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2012-11-09 |
Last Update Date | 2016-12-15 |