Organization
KENTUCKY SLEEP DISORDER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NISHA G DAVE (REGISTERED AGENT)
(502) 222-0330
Entity
Organization
Contact information
Practice address
1006 NEW MOODY LN, LA GRANGE, KY 40031-9122
(502) 222-0330
(502) 222-0390
Mailing address
PO BOX 393, LA GRANGE, KY 40031-0393
(502) 222-0330
(502) 222-0390
Taxonomy
Speciality
Code
Description
License number
State
2278P1004X
Pulmonary Diagnostics Certified Respiratory Therapist
Primary
—
—
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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