Provider First Line Business Practice Location Address:
2228 MARTIN LUTHER KING JR BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARIS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40361-1282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-982-0993
Provider Business Practice Location Address Fax Number:
859-982-0997
Provider Enumeration Date:
07/11/2024