Provider First Line Business Practice Location Address:
1400 CUMBERLAND FALLS HWY STE C
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:
40701-2739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-528-2149
Provider Business Practice Location Address Fax Number:
606-528-2338
Provider Enumeration Date:
06/24/2019