Provider First Line Business Practice Location Address:
H110A CHANDLER MEDICAL CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-710-0704
Provider Business Practice Location Address Fax Number:
859-323-9258
Provider Enumeration Date:
05/12/2012