| NPI | 1942320627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA L HAGAN Owner 859-640-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: KY 004149) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |