Provider First Line Business Practice Location Address:
2250 LEESTOWN ROAD
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-233-4511
Provider Business Practice Location Address Fax Number:
859-281-3823
Provider Enumeration Date:
04/01/2010