Provider First Line Business Practice Location Address:
740 S. LIMESTONE STREET, K401 KENTUCKY CLINIC
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-218-3064
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2009