Provider First Line Business Practice Location Address:
5793 LAWRENCEBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAPLIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40012-8000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-373-7832
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2018