Provider First Line Business Practice Location Address:
1000 S 5TH ST
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:
40203-3210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-893-3900
Provider Business Practice Location Address Fax Number:
502-893-9646
Provider Enumeration Date:
11/13/2006