Provider First Line Business Practice Location Address:
198 BLUEGRASS DR
Provider Second Line Business Practice Location Address:
BALLARD COUNTY HEALTH CENTER
Provider Business Practice Location Address City Name:
LACENTER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-665-5432
Provider Business Practice Location Address Fax Number:
270-665-9166
Provider Enumeration Date:
04/12/2006