Provider First Line Business Practice Location Address:
132 MINI MALL DRIVE
Provider Second Line Business Practice Location Address:
BEREA HEALTH MINISTRY, INC.
Provider Business Practice Location Address City Name:
BEREA
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40403-1170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-986-1274
Provider Business Practice Location Address Fax Number:
859-986-1279
Provider Enumeration Date:
01/03/2007