Provider First Line Business Practice Location Address:
UNIVERSITY OF KENTUCKY DEPT OF PEDS MN140C
Provider Second Line Business Practice Location Address:
740 SOUTH LIMESTONE STR.
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-3266
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2011