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Organization

MIISPINE

Active
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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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