PREMISE HEALTH OF WEST VIRGINIA MEDICAL MEDICAL CORPORATION NPI 1942973276

NPI Information

PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION is a multi-specialty clinic center in Covington, KY. PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION NPI is 1942973276. The provider is registered as an organization entity type.
The provider Is Doing Business As Ctk - Covington.

The provider's business location address is:

1840 SIMON KENTON WAY STE 3200
COVINGTON, KY
ZIP 41011-693
Phone: (859) 392-1724
Fax: (407) 366-6663

The provider's authorized official is Jonathan B Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 18D2058873 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/2/2021 and was last updated on 8/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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