Provider First Line Business Practice Location Address:
12601 TOWNEPARK WAY
Provider Second Line Business Practice Location Address:
STE.#100
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40243-2302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-326-8000
Provider Business Practice Location Address Fax Number:
502-326-7900
Provider Enumeration Date:
10/13/2005