Provider First Line Business Practice Location Address:
111 TOWN HOLLOW RD
Provider Second Line Business Practice Location Address:
CLINCH VALLEY TREATMENT CENTER
Provider Business Practice Location Address City Name:
CEDAR BLUFF
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
24609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-963-3554
Provider Business Practice Location Address Fax Number:
276-963-3544
Provider Enumeration Date:
08/07/2007