Provider First Line Business Practice Location Address:
1100 EAST MARKET ST.
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:
40206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-596-1252
Provider Business Practice Location Address Fax Number:
502-596-1420
Provider Enumeration Date:
01/12/2010