Provider First Line Business Practice Location Address:
2945 SCOTTSVILLE RD
Provider Second Line Business Practice Location Address:
KMART PHARMACY
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42104-6331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-782-1481
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2010