Provider First Line Business Practice Location Address:
2225 LAWRENCEBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-9128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-351-2042
Provider Business Practice Location Address Fax Number:
502-480-4157
Provider Enumeration Date:
09/12/2019