Provider First Line Business Practice Location Address:
9800 SHELBYVILLE RD.
Provider Second Line Business Practice Location Address:
STE 220
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40223-2992
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-999-1249
Provider Business Practice Location Address Fax Number:
855-656-7325
Provider Enumeration Date:
07/24/2023