Provider First Line Business Practice Location Address:
181 HIGHWAY 44 E
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SHEPHERDSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40165-6081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-921-1231
Provider Business Practice Location Address Fax Number:
502-921-1275
Provider Enumeration Date:
05/10/2006