| NPI | 1952870479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD E. WALDRIDGE President/Physician Executive 502-210-6010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2019-01-30 |