Provider First Line Business Practice Location Address:
1400 POPLAR LEVEL RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40217-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-637-4800
Provider Business Practice Location Address Fax Number:
502-637-1550
Provider Enumeration Date:
08/13/2006