Provider First Line Business Practice Location Address:
507 JOSEPH DR STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330-2119
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-734-2800
Provider Business Practice Location Address Fax Number:
859-734-2805
Provider Enumeration Date:
02/06/2006