Provider First Line Business Practice Location Address:
110 DIAGNOSTIC DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-6557
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-219-7937
Provider Business Practice Location Address Fax Number:
502-219-7948
Provider Enumeration Date:
08/26/2006