Provider First Line Business Practice Location Address:
101 W MUHAMMAD ALI BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1423
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-589-8600
Provider Business Practice Location Address Fax Number:
502-287-0662
Provider Enumeration Date:
05/30/2006