Provider First Line Business Practice Location Address:
1400 CUMBERLAND FALLS HWY
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:
40701-2739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-258-8787
Provider Business Practice Location Address Fax Number:
606-258-8788
Provider Enumeration Date:
05/22/2006