Kentucky Blue Medical LLC
NPI #1063862506 in Louisville, Kentucky
Provider Information
- NPI Number
- 1063862506
- Entity Type
- Organization
- Organization Name
- Kentucky Blue Medical LLC
- Primary Specialty
- Neuromusculoskeletal Medicine & OMM
- Enumeration Date
- Jun 15, 2016
- Last Updated
- Jun 15, 2016
Practice Location
- Address
- 4602 SOUTHERN PKWY STE 1A
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40214-1442
- Phone
- (502) 361-1159
Authorized Official
- Name
- CRANSTON SHEPPARD
- Title
- OWNER
- Phone
- (502) 361-1159
Specialties & Taxonomy Codes
| Specialty |
|---|
| Neuromusculoskeletal Medicine & OMM |
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