Provider First Line Business Practice Location Address:
4001 KRESGE WAY
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:
40207-4640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-897-7416
Provider Business Practice Location Address Fax Number:
502-895-6638
Provider Enumeration Date:
02/09/2006