Provider First Line Business Practice Location Address:
562 HWY 80 W.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COMBS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41729-0194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-439-3740
Provider Business Practice Location Address Fax Number:
606-436-2261
Provider Enumeration Date:
03/27/2007