Provider First Line Business Practice Location Address:
6800 HWY. US23 SOUTH
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
PIKEVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41501-6800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-639-8223
Provider Business Practice Location Address Fax Number:
606-639-8233
Provider Enumeration Date:
05/04/2006