| NPI | 1992978365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADHIKA NAIR Practice Administrator 502-995-4004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: KY 6922560001) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2021-03-23 |