Provider First Line Business Practice Location Address:
159 KY 680 EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAROLD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-478-1600
Provider Business Practice Location Address Fax Number:
606-478-1604
Provider Enumeration Date:
10/26/2010