Provider First Line Business Practice Location Address:
1419 CUMBERLAND FALLS HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORBIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40701-2722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-528-4481
Provider Business Practice Location Address Fax Number:
606-528-6531
Provider Enumeration Date:
11/08/2016