Provider First Line Business Practice Location Address:
101 WEST CHESTNUT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-289-2212
Provider Business Practice Location Address Fax Number:
859-289-4744
Provider Enumeration Date:
06/22/2006