Provider First Line Business Practice Location Address:
110 DIAGNOSTIC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-223-7186
Provider Business Practice Location Address Fax Number:
502-223-7186
Provider Enumeration Date:
11/09/2006