Provider First Line Business Practice Location Address:
1654 US 60 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEDBETTER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-898-2527
Provider Business Practice Location Address Fax Number:
270-898-7811
Provider Enumeration Date:
03/08/2007