Provider First Line Business Practice Location Address:
1710 CUMBERLAND FALLS HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORBIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40701-2727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-528-6700
Provider Business Practice Location Address Fax Number:
606-528-6513
Provider Enumeration Date:
08/02/2005