Provider First Line Business Practice Location Address:
1075 HIGHWAY 11 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEATTYVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41311-9240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-464-3901
Provider Business Practice Location Address Fax Number:
606-464-8888
Provider Enumeration Date:
08/02/2022