Provider First Line Business Practice Location Address:
100 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42003-7909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-205-5913
Provider Business Practice Location Address Fax Number:
270-442-1001
Provider Enumeration Date:
04/26/2006