Provider First Line Business Practice Location Address:
120 SOUTH 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARLOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-534-8999
Provider Business Practice Location Address Fax Number:
270-534-1670
Provider Enumeration Date:
06/12/2007