Provider First Line Business Practice Location Address:
601 S FLOYD ST
Provider Second Line Business Practice Location Address:
STE 350
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-629-2030
Provider Business Practice Location Address Fax Number:
502-629-2070
Provider Enumeration Date:
04/20/2006