Provider First Line Business Practice Location Address:
112 BANK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARDINSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40143-3545
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-756-1700
Provider Business Practice Location Address Fax Number:
270-756-6205
Provider Enumeration Date:
01/25/2012