Provider First Line Business Practice Location Address:
1226 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:
40701-2717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-526-0593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2007