Provider First Line Business Practice Location Address:
1100 WEST SHELBY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-654-3232
Provider Business Practice Location Address Fax Number:
859-654-3277
Provider Enumeration Date:
11/16/2006