Provider First Line Business Practice Location Address:
20 MEDICAL VILLAGE DRIVE
Provider Second Line Business Practice Location Address:
#258 INDEPENDENT ANESTHESIOLOGISTS PSC
Provider Business Practice Location Address City Name:
EDGEWOOD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-341-7246
Provider Business Practice Location Address Fax Number:
859-341-7867
Provider Enumeration Date:
10/23/2006