Provider First Line Business Practice Location Address:
245 FLEMINGSBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40351-1015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-780-5500
Provider Business Practice Location Address Fax Number:
606-780-5512
Provider Enumeration Date:
10/11/2006