COMMONWEALTH OF KENTUCKY

NPI # 

Practice Address:

1800 Bluegrass Ave

Louisville, KY, 40215-1130

Practice Phone:

502-361-2301

Practice Fax:

502-366-0367

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Multi-Specialty

Taxonomy Code:

261QM1300X