Provider First Line Business Practice Location Address:
1011 OLD HIGHWAY 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARDINSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40143-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-756-7000
Provider Business Practice Location Address Fax Number:
817-539-3073
Provider Enumeration Date:
03/30/2018