Organization
LOUISVILLE & SO INDIANA PULMONARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY L RALSTON (PRACTICE ADMINISTATOR)
(502) 368-9561
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, STE 409, LOUISVILLE, KY 40215-1190
(502) 368-9561
(502) 882-1263
Mailing address
4402 CHURCHMAN AVE, STE 409, LOUISVILLE, KY 40215-1190
(502) 368-9561
(502) 882-1263
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
3008801
KY
Other
Enumeration date
08/06/2014
Last updated
08/06/2014
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