Provider First Line Business Practice Location Address:
1779 HIGHWAY 44 E STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHEPHERDSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40165-6132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-281-4860
Provider Business Practice Location Address Fax Number:
502-281-4860
Provider Enumeration Date:
06/25/2010