Organization
SALON ASA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL FRANKLIN GUMBERT (ADMINISTRATOR)
(859) 276-5335
Entity
Organization
Contact information
Practice address
431 SOUTHLAND DR, LEXINGTON, KY 40503-1826
(859) 276-5335
Mailing address
431 SOUTHLAND DR, LEXINGTON, KY 40503-1826
(859) 276-5335
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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