Provider First Line Business Practice Location Address:
17401 KY HIGHWAY 80 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKHORN CITY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41522-8226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-754-7100
Provider Business Practice Location Address Fax Number:
606-754-0770
Provider Enumeration Date:
03/07/2014