Provider First Line Business Practice Location Address:
1700 US HIGHWAY 60 W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MORGANFIELD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42437-6242
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-389-0031
Provider Business Practice Location Address Fax Number:
270-389-3707
Provider Enumeration Date:
08/31/2006