Provider First Line Business Practice Location Address:
THE KENTUCKY CLINIC WING D J252
Provider Second Line Business Practice Location Address:
740 S. LIMESTONE
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-323-2089
Provider Business Practice Location Address Fax Number:
859-218-7487
Provider Enumeration Date:
02/05/2007