# KENTUCKIANA PREMIER PST CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** KPTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124393285
- **Authorized official:** TOM LUMLEY (CFO)
- **Authorized official phone:** (502) 532-1811

## Contact information

- **Practice address:** 605 N SHORE DR, STE 202, JEFFERSONVILLE, IN 47130-3134
- **Practice address phone:** (502) 532-1811
- **Practice address fax:** (502) 410-0445
- **Mailing address:** 605 N SHORE DR, STE 202, JEFFERSONVILLE, IN 47130-3134
- **Mailing address phone:** (502) 532-1811
- **Mailing address fax:** (502) 410-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 03/21/2012
- **Last updated:** 03/21/2012