Provider First Line Business Practice Location Address:
215 E 11TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41071-2203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-655-6100
Provider Business Practice Location Address Fax Number:
859-655-6186
Provider Enumeration Date:
10/26/2021