Provider First Line Business Practice Location Address:
130 MIDDLE SCHOOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41267-8300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-263-6500
Provider Business Practice Location Address Fax Number:
866-927-9488
Provider Enumeration Date:
08/08/2022