Provider First Line Business Practice Location Address:
50 STERLING AVE
Provider Second Line Business Practice Location Address:
BOX 7
Provider Business Practice Location Address City Name:
MT STERLING
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40353-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-497-7781
Provider Business Practice Location Address Fax Number:
859-497-6017
Provider Enumeration Date:
01/27/2006