Provider First Line Business Practice Location Address:
2620 PERKINS DR
Provider Second Line Business Practice Location Address:
VA MEDICAL CLINIC CBOC
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-443-8198
Provider Business Practice Location Address Fax Number:
270-443-7734
Provider Enumeration Date:
07/06/2006