Provider First Line Business Practice Location Address:
601 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
390
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41071-1986
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-291-4800
Provider Business Practice Location Address Fax Number:
859-655-8588
Provider Enumeration Date:
03/24/2006