Provider First Line Business Practice Location Address:
200 ABRAHAM FLEXNER WAY
Provider Second Line Business Practice Location Address:
2ND FL FRAZIER INST.
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-587-3999
Provider Business Practice Location Address Fax Number:
502-587-3960
Provider Enumeration Date:
10/25/2006