Provider First Line Business Practice Location Address:
105 DIAGNOSTIC DR STE B
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:
40601-6559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-338-0466
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2026