Provider First Line Business Practice Location Address:
101 MEDICAL HEIGHTS DR STE F
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:
40601-4137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-875-1766
Provider Business Practice Location Address Fax Number:
502-875-1766
Provider Enumeration Date:
04/01/2020