Provider First Line Business Practice Location Address:
208 S COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42164-1263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-239-4000
Provider Business Practice Location Address Fax Number:
270-796-9328
Provider Enumeration Date:
06/09/2005