| NPI | 1982492716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA C GUY COO/Cso 502-310-6723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QC1500X Clinic/Center Community Health | |
| Enumeration Date | 2025-04-30 |
| Last Update Date | 2025-04-30 |