Provider First Line Business Practice Location Address:
1040 HIGHWAY 44 E
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:
40165-6122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-543-2271
Provider Business Practice Location Address Fax Number:
502-543-3608
Provider Enumeration Date:
01/30/2007