Provider First Line Business Practice Location Address:
5232 US HIGHWAY 194E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINSER
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-205-1982
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2022