Provider First Line Business Practice Location Address:
16 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-845-2803
Provider Business Practice Location Address Fax Number:
502-845-2834
Provider Enumeration Date:
01/08/2007