Provider First Line Business Practice Location Address:
1270 LOUISVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330-8611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-223-7403
Provider Business Practice Location Address Fax Number:
502-223-5016
Provider Enumeration Date:
02/26/2026