Embrase, LLC
Clinic/Center, Primary Care in London, KY. Organization (NPI-2).
NPI number1053008508
StatusActive
Last updated in NPPESJul 10, 2023
Details
- NPI
- 1053008508
- Entity type
- Organization (NPI-2)
- Legal business name
- Embrase, LLC
- Organization subpart
- No
- Enumeration date
- Apr 24, 2023
- Certification date
- Jul 10, 2023
- Last updated
- Jul 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Other names
- Embrase Med Spa (Doing Business As)
Practice location
202 N Hill StLondon, KY 40741-1360
Phone 606-260-8811 · Fax 606-260-8812
Mailing address
202 N Hill StLondon, KY 40741-1360
Phone 606-260-8811 · Fax 606-260-8812
Authorized official
Dale Slusser
Office Manager
6062608811
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