Provider First Line Business Practice Location Address:
7008 WOODED MEADOW RD
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:
40241-6411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-600-9042
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2006