Provider First Line Business Practice Location Address:
1918 HIKES LANE, SUITE 102
Provider Second Line Business Practice Location Address:
JENCARE NEIGHBORHOOD MEDICAL NEWBURG, LLC
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-473-4067
Provider Business Practice Location Address Fax Number:
502-473-4077
Provider Enumeration Date:
05/20/2006