Provider First Line Business Practice Location Address:
BLUEGRASS CARE CLINIC
Provider Second Line Business Practice Location Address:
740 S. LIMESTONE L511
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-218-3815
Provider Business Practice Location Address Fax Number:
859-257-4953
Provider Enumeration Date:
08/30/2016