Provider First Line Business Practice Location Address:
1225 US HIGHWAY 60 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOREHEAD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40351-9271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-336-8134
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2026