Provider First Line Business Practice Location Address:
3730 FRANKFORT AVE
Provider Second Line Business Practice Location Address:
#203
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207-2582
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-409-9300
Provider Business Practice Location Address Fax Number:
502-409-9307
Provider Enumeration Date:
08/18/2006