Provider First Line Business Practice Location Address:
1970 HIGHWAY 160 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HINDMAN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-633-4871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2023