Provider First Line Business Practice Location Address:
105 DIAGNOSTIC DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-6559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-352-2208
Provider Business Practice Location Address Fax Number:
502-352-2209
Provider Enumeration Date:
01/11/2012