Provider First Line Business Practice Location Address:
182 FRANKFORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBYVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40065-9433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-437-3008
Provider Business Practice Location Address Fax Number:
502-437-3607
Provider Enumeration Date:
01/22/2024