Provider First Line Business Practice Location Address:
1225 US HIGHWAY 60 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40351-6827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-436-8504
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2025