Provider First Line Business Practice Location Address:
1090 INDUSTRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330-9140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-375-9200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2012