Organization
FERN CREEK TRADITIONAL HIGH SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY P AMSHOFF (ATHLETIC DIRECTOR)
(502) 538-4951
Entity
Organization
Contact information
Practice address
9115 FERN CREEK RD, LOUISVILLE, KY 40291-2711
(502) 553-0470
(502) 485-8009
Mailing address
195 AULBERN DR E, MT WASHINGTON, KY 40047-6300
(502) 553-0470
(502) 485-8009
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
AT445
KY
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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