Provider First Line Business Practice Location Address:
103 DIAGNOSTIC DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-6524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-977-8855
Provider Business Practice Location Address Fax Number:
859-278-8856
Provider Enumeration Date:
05/01/2007