Provider First Line Business Practice Location Address:
5020 NORTON HEALTHCARE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40241-2835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-420-0173
Provider Business Practice Location Address Fax Number:
502-420-0174
Provider Enumeration Date:
04/19/2012