Provider First Line Business Practice Location Address:
231 E CHESTNUT ST
Provider Second Line Business Practice Location Address:
KOSAIR CHILDRENS HOSPITAL
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-451-9949
Provider Business Practice Location Address Fax Number:
502-451-4553
Provider Enumeration Date:
12/13/2010