Provider First Line Business Practice Location Address:
5230 KY ROUTE 321 STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PRESTONSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41653-9169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-459-5001
Provider Business Practice Location Address Fax Number:
606-548-5477
Provider Enumeration Date:
09/13/2023