Provider First Line Business Practice Location Address:
332 NORTH COURT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-997-4040
Provider Business Practice Location Address Fax Number:
833-214-0912
Provider Enumeration Date:
06/01/2005