Provider First Line Business Practice Location Address:
820 S. 6TH ST
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:
40203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-568-1000
Provider Business Practice Location Address Fax Number:
502-736-9369
Provider Enumeration Date:
11/07/2008