Provider First Line Business Practice Location Address:
2811 KLEMPNER WAY
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:
40205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-896-6355
Provider Business Practice Location Address Fax Number:
502-896-9813
Provider Enumeration Date:
10/11/2006