Provider First Line Business Practice Location Address:
455 SOUTH 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40203-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-587-7246
Provider Business Practice Location Address Fax Number:
502-587-7266
Provider Enumeration Date:
02/28/2007