Provider First Line Business Practice Location Address:
105 CAMPUS DR
Provider Second Line Business Practice Location Address:
ADDICTION RECOVERY CARE, LOUISA OFFICE LOCATION
Provider Business Practice Location Address City Name:
ANNBILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-681-6390
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2016