Provider First Line Business Practice Location Address:
108 DIAGNOSTIC DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-6556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-226-5360
Provider Business Practice Location Address Fax Number:
502-223-9829
Provider Enumeration Date:
05/05/2010