Provider First Line Business Practice Location Address:
14659 N US HIGHWAY 25 E STE 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORBIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40701-5180
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-280-7070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2025