Provider First Line Business Practice Location Address:
213 MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41006-0231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-472-6011
Provider Business Practice Location Address Fax Number:
859-472-6030
Provider Enumeration Date:
01/23/2008