Provider First Line Business Practice Location Address:
4831 US HIGHWAY 42 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GHENT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41045-9001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-567-3100
Provider Business Practice Location Address Fax Number:
859-567-1094
Provider Enumeration Date:
04/02/2019