Provider First Line Business Practice Location Address:
440 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-734-2229
Provider Business Practice Location Address Fax Number:
859-734-2968
Provider Enumeration Date:
05/29/2008