Provider First Line Business Practice Location Address:
KENTUCKY CLINIC E214 740 SOUTH LIMESTONE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-5500
Provider Business Practice Location Address Fax Number:
859-323-0001
Provider Enumeration Date:
04/30/2014