Provider First Line Business Practice Location Address:
1439 US 127-BYPASS NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCEBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40342-9402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-320-1307
Provider Business Practice Location Address Fax Number:
502-223-0303
Provider Enumeration Date:
09/04/2006