Provider First Line Business Practice Location Address:
7139 HWY 56 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEBREE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-835-2200
Provider Business Practice Location Address Fax Number:
270-835-2204
Provider Enumeration Date:
12/31/2009