Provider First Line Business Practice Location Address:
189 WEST HIGHWAY 192 BYPASS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONDON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40741-2428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-252-6500
Provider Business Practice Location Address Fax Number:
606-877-5454
Provider Enumeration Date:
02/24/2006