Provider First Line Business Practice Location Address:
727 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELBYVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40065-1660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-647-4347
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2005