| NPI | 1821270653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS KOFORD Medical Director 502-447-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: KY 35781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 39534) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-04 |