Provider First Line Business Practice Location Address:
3343 LEXINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40361-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-987-2180
Provider Business Practice Location Address Fax Number:
859-987-2182
Provider Enumeration Date:
12/01/2010