Provider First Line Business Practice Location Address:
2085 US HIGHWAY 460 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRENCHBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40322-8384
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-768-3725
Provider Business Practice Location Address Fax Number:
606-464-0152
Provider Enumeration Date:
01/27/2023