Provider First Line Business Practice Location Address:
1 PHYSICIANS PARK
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:
40601-4192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-223-7629
Provider Business Practice Location Address Fax Number:
502-223-7620
Provider Enumeration Date:
03/31/2009