Provider First Line Business Practice Location Address:
70 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRENCHBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-738-2131
Provider Business Practice Location Address Fax Number:
606-738-2134
Provider Enumeration Date:
02/02/2007