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General NPI Number Information
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NPI Number | 1639834757
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Entity Type | Organization
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Legal Business Name | KNEEWORX MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 1169 EASTERN PKWY STE 3450
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City | LOUISVILLE
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State | KY
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Zip | 40217-1417
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Country | US
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Telephone | 602-510-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 312 S 4TH ST STE 700
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City | LOUISVILLE
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State | KY
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Zip | 40202-3046
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Country | US
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Telephone | 888-828-1927
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. GREGORY POVENSKI JR.
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Credential |
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Telephone | 800-920-6748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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