Provider First Line Business Practice Location Address:
ELY HOME INFUSION
Provider Second Line Business Practice Location Address:
109 MORAN STREET STE A
Provider Business Practice Location Address City Name:
GLASGOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-467-5220
Provider Business Practice Location Address Fax Number:
270-629-6320
Provider Enumeration Date:
08/31/2006