Provider First Line Business Practice Location Address:
4950 NORTON HEALTHCARE BLVD.
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-425-5556
Provider Business Practice Location Address Fax Number:
502-992-0079
Provider Enumeration Date:
06/07/2006