Provider First Line Business Practice Location Address:
7240 S US HWY 231
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47542-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-608-4280
Provider Business Practice Location Address Fax Number:
812-683-2215
Provider Enumeration Date:
09/21/2009