Organization
MARSHALL LIFESTYLE MEDICINE, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KITCHEN (CHIEF OPERATING OFFICER)
(859) 608-4841
Entity
Organization
Contact information
Practice address
2251 WAR ADMIRAL WAY, SUITE 125, LEXINGTON, KY 40509-2546
(859) 608-4841
Mailing address
2105 WICKSBURY PL, LEXINGTON, KY 40515-1168
(859) 608-4841
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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