Provider First Line Business Practice Location Address:
101 E COLLEGE ST
Provider Second Line Business Practice Location Address:
#1
Provider Business Practice Location Address City Name:
GEORGETOWN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40324-1603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-570-8400
Provider Business Practice Location Address Fax Number:
502-570-9221
Provider Enumeration Date:
09/26/2006