Provider First Line Business Practice Location Address:
1553 HIGHWAY 44 E STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHEPHERDSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40165-7183
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-921-0055
Provider Business Practice Location Address Fax Number:
502-805-0056
Provider Enumeration Date:
05/09/2007