Provider First Line Business Practice Location Address:
550 S. JACKSON ST.
Provider Second Line Business Practice Location Address:
2ND FLOOR ACB, DEPARTMENT OF SURGERY
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-904-3004
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2023