Provider Demographics
NPI:1568778165
Name:IMPROMED CORP
Entity Type:Organization
Organization Name:IMPROMED CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-907-1306
Mailing Address - Street 1:2901 RICHMOND RD
Mailing Address - Street 2:SUITE 130-301
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1771
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2901 RICHMOND RD
Practice Address - Street 2:SUITE 130-301
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1771
Practice Address - Country:US
Practice Address - Phone:859-907-1306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty