Provider First Line Business Practice Location Address:
7807 SHELBYVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40222-5439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-429-6500
Provider Business Practice Location Address Fax Number:
502-429-0770
Provider Enumeration Date:
11/16/2005