Provider First Line Business Practice Location Address:
7415 HWY 160 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTCARR
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-642-3040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2006