Provider First Line Business Practice Location Address:
4813 TAYLORSVILLE RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40071
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-477-0300
Provider Business Practice Location Address Fax Number:
502-477-0303
Provider Enumeration Date:
09/07/2010