Provider First Line Business Practice Location Address:
601 S FLOYD ST
Provider Second Line Business Practice Location Address:
500
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-589-8033
Provider Business Practice Location Address Fax Number:
502-589-0805
Provider Enumeration Date:
04/23/2009