Provider First Line Business Practice Location Address:
1451 HIGHWAY 44 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHEPHERDSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40165-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-955-5328
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2006