Provider First Line Business Practice Location Address:
2157 S HIGHWAY 27
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEARNS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42647-6297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-376-9700
Provider Business Practice Location Address Fax Number:
606-376-9703
Provider Enumeration Date:
01/14/2022