Provider First Line Business Practice Location Address:
2301 LEXINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 135
Provider Business Practice Location Address City Name:
ASHLAND
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41101-2873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-324-3333
Provider Business Practice Location Address Fax Number:
606-324-5515
Provider Enumeration Date:
04/01/2008