Provider First Line Business Practice Location Address:
396 E CROSS MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40050-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-368-5154
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2013