Provider First Line Business Practice Location Address:
2796 S.R. 2153
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-333-7223
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2007