Provider First Line Business Practice Location Address:
85 N GRAND AVENUE
Provider Second Line Business Practice Location Address:
ST LUKE HOSPITAL EAST
Provider Business Practice Location Address City Name:
FORT THOMAS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-572-3880
Provider Business Practice Location Address Fax Number:
859-572-3895
Provider Enumeration Date:
10/25/2006