Provider First Line Business Practice Location Address:
200 MEDICAL CENTER DR STE 1N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAZARD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41701-9477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-439-5051
Provider Business Practice Location Address Fax Number:
606-436-4655
Provider Enumeration Date:
05/05/2008