Provider First Line Business Practice Location Address:
211 WASHINGTON ST
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:
40601-1821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-227-7430
Provider Business Practice Location Address Fax Number:
502-227-7166
Provider Enumeration Date:
04/18/2007