Provider First Line Business Practice Location Address:
103 DIAGNOSTIC DR STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-352-2468
Provider Business Practice Location Address Fax Number:
859-987-3273
Provider Enumeration Date:
07/18/2012