Provider First Line Business Practice Location Address:
DEPARTMENT OF OTOLARYNGOLOGY AND COMMUNICATIVE DISORDER
Provider Second Line Business Practice Location Address:
529 S JACKSON ST, THIRD 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-561-7268
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/20/2020