| NPI | 1922072164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN A NETHERY Office Manager 502-897-7411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 25785) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 31692) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-08-22 |