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NPI 1891583589

NPI 1891583589 : EMBODY HEALTH PLLC : FT WRIGHT, KY

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General NPI Number Information
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    NPI Number           |    1891583589
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    Entity Type          |    Organization 
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    Legal Business Name  |    EMBODY HEALTH PLLC 
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Dates
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    Enumeration Date     |    04/30/2025
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    Last Update Date     |    04/30/2025
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Provider Practice Location Address
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    Address Line         |    1717 DIXIE HWY STE 970 
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    City                 |    FT WRIGHT
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    State                |    KY
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    Zip                  |    41011-2791
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    Country              |    US
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    Telephone            |    859-320-9300
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    Fax                  |    859-320-9301
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Provider Business Mailing Address
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    Address Line         |    1717 DIXIE HWY STE 970 
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    City                 |    FT WRIGHT
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    State                |    KY
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    Zip                  |    41011-2791
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    Country              |    US
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    Telephone            |    859-320-9300
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    Fax                  |    859-320-9301
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Authorized Official
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    Title or Position    |    PHYSICIAN
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    Name                 |    DR. SHEENA  BOURY 
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    Credential           |    MD
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    Telephone            |    859-320-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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