Provider First Line Business Practice Location Address:
800 CALDWELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003-6928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-444-5600
Provider Business Practice Location Address Fax Number:
270-444-5607
Provider Enumeration Date:
08/04/2012