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Organization

PAIN AND WELLNESS INSTITUTE OF KENTUCKY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTAL WILSON MD (OWNER)
(502) 876-6474
Entity
Organization

Contact information

Practice address
10302 BROOKRIDGE VILLAGE BLVD STE 103-104, LOUISVILLE, KY 40291-4475
(502) 576-5300
(502) 576-5376
Mailing address
10302 BROOKRIDGE VILLAGE BLVD STE 103-104, LOUISVILLE, KY 40291-4475
(502) 576-5300
(502) 576-5376

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
363L00000X
Nurse Practitioner

Other

Enumeration date
06/08/2022
Last updated
03/19/2025
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