MEDICARE: IMPROMED CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	32025	KY

General Provider Information

NPI Number	:	1568778165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMPROMED CORP

Provider Business Mailing Address
First Line	:	2901 RICHMOND RD
Second Line	:	SUITE 130-301
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1771
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 RICHMOND RD
Second Line	:	SUITE 130-301
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1771
Country	:	US
Telephone Number	:	859-907-1306
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KYLE KING
Credential	:
Telephone Number	:	859-907-1306

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	08/20/2010

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Directions to “IMPROMED CORP ” Practice Location

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