Provider First Line Business Practice Location Address:
1305 HANDY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330-8789
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-613-4124
Provider Business Practice Location Address Fax Number:
859-748-6006
Provider Enumeration Date:
06/09/2006