Organization
MIISPINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENU VEMURI DO (OWNER)
(502) 242-6370
Entity
Organization
Contact information
Practice address
6420 DUTCHMANS PKWY STE 160, LOUISVILLE, KY 40205-3353
(502) 242-6370
(502) 242-6540
Mailing address
6420 DUTCHMANS PKWY STE 160, LOUISVILLE, KY 40205-3353
(502) 242-6370
(502) 242-6540
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/11/2020
Last updated
07/17/2024
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