Provider First Line Business Practice Location Address:
1605 SCHERM RD
Provider Second Line Business Practice Location Address:
#3
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42301-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-685-9499
Provider Business Practice Location Address Fax Number:
270-685-9443
Provider Enumeration Date:
02/19/2008