| NPI | 1801498720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY BROMAGEN FOUCH Owner 859-498-5243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2022-04-13 |