Provider First Line Business Practice Location Address:
175 MEDICAL HEIGHTS DR
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:
40601-6520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-226-2836
Provider Business Practice Location Address Fax Number:
502-226-1998
Provider Enumeration Date:
10/27/2006