Organization
PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION
Active
Other names
Premise Health Wellness Center - Louisville
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
10000 BROWNSBORO RD STE 7, LOUISVILLE, KY 40241-3900
(502) 272-0330
(502) 272-0332
Mailing address
5500 MARYLAND WAY, BRENTWOOD, TN 37027-7048
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
08/15/2022
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