Provider First Line Business Practice Location Address:
650 JOEL DRIVE
Provider Second Line Business Practice Location Address:
DEPT. OF BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
FORT CAMPBELL, KY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42223-5349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-956-0620
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/31/2007