Provider First Line Business Practice Location Address:
1101 VETERANS DR
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER (116A4-LD)
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40502-2236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-281-3817
Provider Business Practice Location Address Fax Number:
859-281-3919
Provider Enumeration Date:
04/12/2006