Provider First Line Business Practice Location Address:
2157 S. HWY 27
Provider Second Line Business Practice Location Address:
STE # 2
Provider Business Practice Location Address City Name:
STEARNS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-376-9662
Provider Business Practice Location Address Fax Number:
606-376-9658
Provider Enumeration Date:
11/28/2018