| NPI | 1922840057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE A PALAU Owner 502-384-2515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| 225100000X Physical Therapist | |
| 251S00000X | |
| Enumeration Date | 2024-06-10 |
| Last Update Date | 2024-06-10 |