Provider First Line Business Practice Location Address:
236 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRESTONSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41653-1214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-257-2333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2006