Provider First Line Business Practice Location Address:
550 U. S. HWY 62 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRINCETON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-365-3793
Provider Business Practice Location Address Fax Number:
270-365-3896
Provider Enumeration Date:
10/03/2006