Provider First Line Business Practice Location Address:
50 PROFESSOR CLARKE CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HINDMAN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41822-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-886-8240
Provider Business Practice Location Address Fax Number:
606-886-8243
Provider Enumeration Date:
10/29/2009