Provider First Line Business Practice Location Address:
145 WATER PLANT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STEARNS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42647-6115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-539-4686
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2012