Provider First Line Business Practice Location Address:
1300 US HIGHWAY 127 S STE 115
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-4379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-223-3728
Provider Business Practice Location Address Fax Number:
502-223-3790
Provider Enumeration Date:
11/20/2006