Provider First Line Business Practice Location Address:
10897 SOUTH KENTUCKY HWY 15
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCUDDY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-551-1069
Provider Business Practice Location Address Fax Number:
606-435-7558
Provider Enumeration Date:
11/13/2024