Provider First Line Business Practice Location Address:
510 E PARRISH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42303-3125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-688-5888
Provider Business Practice Location Address Fax Number:
270-688-8238
Provider Enumeration Date:
04/03/2006