Provider First Line Business Practice Location Address:
4604 US HIGHWAY 60 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-389-5523
Provider Business Practice Location Address Fax Number:
270-389-5526
Provider Enumeration Date:
11/23/2016