| NPI | 1972782712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY B MASHBURN Owner/President 859-234-8852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: KY 36048) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA1557) |
| Enumeration Date | 2007-10-29 |
| Last Update Date | 2011-03-07 |