Provider First Line Business Practice Location Address:
11155 US HWY 23 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETSY LAYNE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41605-4160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-478-9474
Provider Business Practice Location Address Fax Number:
606-478-1000
Provider Enumeration Date:
02/26/2007