Provider First Line Business Practice Location Address:
3251 BEAUMONT CIRCLE
Provider Second Line Business Practice Location Address:
SAINT JOSEPH HEALTHY LIFESTYLE CENTER
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-219-0530
Provider Business Practice Location Address Fax Number:
859-219-0721
Provider Enumeration Date:
08/29/2014