OrganizationActive
Pain and Wellness Institute of Kentucky LLC
NPI 1336878909 · Interventional Pain Medicine Physician · Louisville, KY
Provider details
- NPI number
- 1336878909
- Entity type
- Organization
- Primary specialty
- Interventional Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kristal Wilson, Owner(502) 876-6474
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Suppliers
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
10302 Brookridge Village Blvd Ste 103-104
Louisville, KY 40291-4475
Phone: (502) 576-5300
Fax: (502) 576-5376
Approximate (ZIP-level) locationGet directions
Mailing address
10302 Brookridge Village Blvd Ste 103-104
Louisville, KY 40291-4475
Registry dates
- Enumerated
- 2022-06-08
- Last updated
- 2025-03-19
- Certified
- 2025-03-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.