Premise Health of West Virginia Medical, Medical Corporation
NPI #1104317734 in Louisville, Kentucky
Provider Information
- NPI Number
- 1104317734
- Entity Type
- Organization
- Organization Name
- Premise Health of West Virginia Medical, Medical Corporation
- Primary Specialty
- Clinic/Center
- Enumeration Date
- May 18, 2018
- Last Updated
- Aug 15, 2022
Practice Location
- Address
- 908 W BROADWAY FL 8
- City
- Louisville
- State
- Kentucky
- ZIP Code
- 40203
- Phone
- (502) 779-6015
Authorized Official
- Name
- DR. JON LEIZMAN, MD
- Title
- PRESIDENT
- Phone
- (216) 479-9063
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