Provider First Line Business Practice Location Address:
11437 CUMBERLAND FALLS HWY
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:
40701-7821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-893-1163
Provider Business Practice Location Address Fax Number:
606-620-4410
Provider Enumeration Date:
05/15/2014