Provider First Line Business Practice Location Address:
401 E 20TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-292-4100
Provider Business Practice Location Address Fax Number:
859-292-4106
Provider Enumeration Date:
06/07/2006