Provider First Line Business Practice Location Address:
2135 ARGILLITE RD STE J
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLATWOODS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41139-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-836-8153
Provider Business Practice Location Address Fax Number:
606-834-9420
Provider Enumeration Date:
04/11/2008