Provider First Line Business Practice Location Address:
3755 LAWRENCEBURG RD
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:
40601-8412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-227-9529
Provider Business Practice Location Address Fax Number:
502-227-7191
Provider Enumeration Date:
02/12/2007