Provider First Line Business Practice Location Address:
225 MEDICAL CENTER DR STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003-7914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-441-4500
Provider Business Practice Location Address Fax Number:
270-441-4171
Provider Enumeration Date:
12/03/2007