New Jackson Manor, Llc

NPI 1407845639 - Clinic/Center - 261QA0600X

NPI Details
NPI 1407845639
Enumeration Date 10/20/2005
Last Updated 10/23/2012
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name ROBIN L. ROBIN
Position VICE PRESIDENT
Phone (606) 364-5197
Fax (606) 364-2293
Practice Location
68 HWY 3444
ANNVILLE KY, 40402, US
Phone (606) 364-5197
Fax (606) 364-2293
Business Location
9510 ORMSBY STATION ROAD
SUITE 101
LOUISVILLE KY, 40223, US
Phone (502) 753-6004
Fax (502) 753-6104
Toxanomy
Taxonomy Code 261QA0600X
License State
License Number
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According to our database, New Jackson Manor, Llc NPI is 1407845639, taxonomy code is 261QA0600X New Jackson Manor, Llc physically located at 68 Hwy 3444, Annville KY, 40402. NPI Number 1033115704 has the healthcare provider type.

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1407845639 NPI number is provided on an as is basis without warranty of any kind. 1407845639 is maintained by the National Plan & Provider Enumeration System. The contents of New Jackson Manor, Llc are for informational purposes only.