Provider First Line Business Practice Location Address:
225 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 201
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:
270-441-4200
Provider Business Practice Location Address Fax Number:
270-441-4398
Provider Enumeration Date:
10/25/2006