Provider First Line Business Practice Location Address:
1600 HARRODSBURG ROAD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-3706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-536-0740
Provider Business Practice Location Address Fax Number:
859-977-5100
Provider Enumeration Date:
10/04/2006