Provider First Line Business Practice Location Address:
201 NEW GALLATIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42164-8836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-622-7140
Provider Business Practice Location Address Fax Number:
270-622-4649
Provider Enumeration Date:
09/09/2008