| NPI | 1831140565 |
|---|---|
| Other Name | LEGACY PROSTHETICS |
| Doing Business As | FAYETTE SURGICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | CHERYL REICHEL Billing Manager 859-407-7737 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AS0400X Physician Assistant, Surgical | |
| 2086S0129X Surgery, Vascular Surgery | |
| 335E00000X Prosthetic/Orthotic Supplier | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2023-06-14 |