Provider First Line Business Practice Location Address:
101 MEDICAL HEIGHTS DRIVE
Provider Second Line Business Practice Location Address:
SUITE N
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-875-5240
Provider Business Practice Location Address Fax Number:
502-226-7936
Provider Enumeration Date:
06/05/2007