Provider First Line Business Practice Location Address:
1100 CUMBERLAND FALLS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORBIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40701-2715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-275-4878
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2007