Provider First Line Business Practice Location Address:
79 IMAGING DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42503-2869
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-305-8022
Provider Business Practice Location Address Fax Number:
866-249-9994
Provider Enumeration Date:
09/21/2009