Provider First Line Business Practice Location Address:
6162 ZEBULON HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIKEVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-631-9137
Provider Business Practice Location Address Fax Number:
606-631-9021
Provider Enumeration Date:
09/28/2022