Provider Demographics
NPI:1144876814
Name:YOU ONLY LIVE ONCE MEDICAL
Entity type:Organization
Organization Name:YOU ONLY LIVE ONCE MEDICAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KORTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:502-230-2050
Mailing Address - Street 1:821 ULRICH AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1844
Mailing Address - Country:US
Mailing Address - Phone:502-230-2050
Mailing Address - Fax:502-684-8480
Practice Address - Street 1:821 ULRICH AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-1844
Practice Address - Country:US
Practice Address - Phone:502-230-2050
Practice Address - Fax:502-684-8480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-17
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty