Organization
THE WELL WAGON, LLC
Active
Other names
The Well of KY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY M SPAHN FNP-BC (CEO, OWNER)
(812) 430-2633
Entity
Organization
Contact information
Practice address
2124 DOGOON DR, LOUISVILLE, KY 40223-1147
(812) 430-2633
Mailing address
2124 DOGOON DR, LOUISVILLE, KY 40223-1147
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
10/12/2020
Last updated
10/12/2020
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