Provider First Line Business Practice Location Address:
420 TEAYS BRANCH
Provider Second Line Business Practice Location Address:
CAREMORE PAIN MGT
Provider Business Practice Location Address City Name:
PAINTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-789-7246
Provider Business Practice Location Address Fax Number:
606-789-4392
Provider Enumeration Date:
10/03/2005