Provider First Line Business Practice Location Address:
17433 CURRY BRANCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40245-7503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-714-8722
Provider Business Practice Location Address Fax Number:
502-714-8722
Provider Enumeration Date:
12/29/2025