| NPI | 1801136981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN P THORNTON President 502-629-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2020-01-06 |