Provider First Line Business Practice Location Address:
5900 KY HWY 154
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41006-9005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-472-5127
Provider Business Practice Location Address Fax Number:
859-472-5128
Provider Enumeration Date:
07/18/2005