| NPI | 1992336853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN MARIE REIS CEO 859-301-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207R00000X Internal Medicine | |
| 207RM1200X Internal Medicine, Magnetic Resonance Imaging (MRI) | |
| 207RS0010X Internal Medicine, Sports Medicine | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 213E00000X Podiatrist | |
| 225100000X Physical Therapist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2022-08-26 |