Provider First Line Business Practice Location Address:
1325 SHELBYVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAYLORSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40071-7787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-387-5695
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2025