Provider First Line Business Practice Location Address:
A219 KENTUCKY CLINIC
Provider Second Line Business Practice Location Address:
UNIVERSITY OF KENTUCKY
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:
859-257-3462
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2013