Provider First Line Business Practice Location Address:
138 LEADER AVE, OFFICE 241
Provider Second Line Business Practice Location Address:
UNIVERSITY OF KENTUCKY, DEPARTMENT OF PEDIATRICS
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40506-9983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-1432
Provider Business Practice Location Address Fax Number:
859-323-3499
Provider Enumeration Date:
07/06/2005