Provider First Line Business Practice Location Address:
5251 KY ROUTE 321
Provider Second Line Business Practice Location Address:
KENTUCKY SURGICAL ARTS PSC
Provider Business Practice Location Address City Name:
PRESTONSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41653-9114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-886-0682
Provider Business Practice Location Address Fax Number:
606-886-0682
Provider Enumeration Date:
06/01/2007