| NPI | 1821651852 |
|---|---|
| Doing Business As | KENTUCKIANA FOOT AND ANKLE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KEITH WELLINGTON MYRICK Owner/Authorized Official 502-721-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2021-06-02 |