Provider First Line Business Practice Location Address:
1101 VETERANS DRIVE (160-CDD)
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-281-4912
Provider Business Practice Location Address Fax Number:
859-381-5911
Provider Enumeration Date:
03/02/2009