Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | $$$$$$$$$ | KY |
Y | 213ES0000X | Sports Medicine | $$$$$$$$$ | KY |
NPI | 1184236655 |
---|---|
Provider Name | Catherine Michelle Smith |
First Address | Louisville, KY 40222-5097 |
Second Address | Louisville, KY 40222-5097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 20/08/2020 |