Provider First Line Business Practice Location Address:
13 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40050-2538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-845-2345
Provider Business Practice Location Address Fax Number:
502-845-4567
Provider Enumeration Date:
08/18/2014