Provider First Line Business Practice Location Address:
60 MERCY CT
Provider Second Line Business Practice Location Address:
MARCUM & WALLACE HOSPITAL
Provider Business Practice Location Address City Name:
IRVINE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40336-1331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-723-2115
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2007