Provider First Line Business Practice Location Address:
1571 KY HIGHWAY 259 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42210-9206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-597-2181
Provider Business Practice Location Address Fax Number:
270-597-3232
Provider Enumeration Date:
02/22/2016