Provider First Line Business Practice Location Address:
3006 EASTPOINT PKWY
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:
40223-4185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-253-6881
Provider Business Practice Location Address Fax Number:
502-253-6882
Provider Enumeration Date:
03/09/2006