Provider First Line Business Practice Location Address:
12010 SHELBYVILLE RD
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40243-1054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-238-2800
Provider Business Practice Location Address Fax Number:
502-238-2805
Provider Enumeration Date:
06/14/2005