Provider First Line Business Practice Location Address:
506 W 2ND ST
Provider Second Line Business Practice Location Address:
SECOND STREET SCHOOL CLINIC
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40601-2655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-564-7647
Provider Business Practice Location Address Fax Number:
502-564-9586
Provider Enumeration Date:
11/07/2007