Provider First Line Business Practice Location Address:
132 S PUBLIC SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLASGOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42141-2434
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-651-5246
Provider Business Practice Location Address Fax Number:
270-651-1965
Provider Enumeration Date:
12/21/2006