Provider First Line Business Practice Location Address:
2200 EAST PARRISH AVENUE
Provider Second Line Business Practice Location Address:
BUILDING C, LOWER LEVEL SUITE 107
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-663-1309
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2017