Provider First Line Business Practice Location Address:
950 S 1ST ST
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:
40203-2288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-585-9444
Provider Business Practice Location Address Fax Number:
502-585-9466
Provider Enumeration Date:
01/24/2007