Provider Demographics
NPI:1639834757
Name:KNEEWORX MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:KNEEWORX MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:POVENSKI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:800-920-6748
Mailing Address - Street 1:312 S 4TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3046
Mailing Address - Country:US
Mailing Address - Phone:888-828-1927
Mailing Address - Fax:
Practice Address - Street 1:1169 EASTERN PKWY STE 3450
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1417
Practice Address - Country:US
Practice Address - Phone:602-510-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty