Provider First Line Business Practice Location Address:
7321 NEW L AGRANGE ROAD
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-431-3235
Provider Business Practice Location Address Fax Number:
800-431-3235
Provider Enumeration Date:
03/07/2013