Provider First Line Business Practice Location Address:
1230 US HWY 127
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-223-2266
Provider Business Practice Location Address Fax Number:
502-223-2240
Provider Enumeration Date:
07/27/2006