Provider First Line Business Practice Location Address:
111 HAYS COMPLEX
Provider Second Line Business Practice Location Address:
HWY 23
Provider Business Practice Location Address City Name:
BETSY LAYNE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41605-0436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-478-9474
Provider Business Practice Location Address Fax Number:
606-478-1000
Provider Enumeration Date:
10/06/2005