Provider First Line Business Practice Location Address:
501 S 2ND ST
Provider Second Line Business Practice Location Address:
FIRST FLOOR
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-2862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-583-7546
Provider Business Practice Location Address Fax Number:
502-589-3429
Provider Enumeration Date:
01/17/2007