Provider First Line Business Practice Location Address:
532 NORTH BARDSTOWN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT WASHINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-538-4800
Provider Business Practice Location Address Fax Number:
502-538-3040
Provider Enumeration Date:
02/26/2007