Provider First Line Business Practice Location Address:
225 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003-7914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-444-4250
Provider Business Practice Location Address Fax Number:
270-444-4260
Provider Enumeration Date:
05/19/2008