Provider First Line Business Practice Location Address:
50 ADAMS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40050-3054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-845-2861
Provider Business Practice Location Address Fax Number:
502-845-1287
Provider Enumeration Date:
10/12/2006