Provider First Line Business Practice Location Address:
8182 DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40258-1347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-937-7000
Provider Business Practice Location Address Fax Number:
502-937-9375
Provider Enumeration Date:
12/06/2006