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1083471262
KENTUCKY LIFE SOURCE INC
LOUISVILLE, KY
NPI
1083471262
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Entity Type
Organization
Authorized Contact
JACQUELINE SANDERS
Credentialing Admin
502-630-2036
Organization Subpart ?
No
Primary Taxonomy
251S00000X
Enumeration Date
2024-03-04
Last Update Date
2024-03-04
Business Address
KENTUCKY LIFE SOURCE INC
2619 W BROADWAY
LOUISVILLE, KY 40211-1332
Phone number: 502-303-7665
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Mailing Address
KENTUCKY LIFE SOURCE INC
2619 W BROADWAY
LOUISVILLE, KY 40211-1332
Phone number: 502-303-7665
Copy
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