| NPI | 1831495506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATITAYA TRIMBLE Medical Director 859-229-2703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2020-12-22 |