Provider First Line Business Practice Location Address:
3220 IRVIN COBB DRIVE
Provider Second Line Business Practice Location Address:
WALMART PHARMACY
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-442-6404
Provider Business Practice Location Address Fax Number:
270-442-0743
Provider Enumeration Date:
11/09/2020