Provider First Line Business Practice Location Address:
120 N 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARLOW
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42024-9579
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-334-3131
Provider Business Practice Location Address Fax Number:
270-334-3173
Provider Enumeration Date:
06/17/2015