Provider First Line Business Practice Location Address:
911 BY PASS ROAD CLINIC 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PIKEVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41501-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-218-6406
Provider Business Practice Location Address Fax Number:
606-218-7506
Provider Enumeration Date:
08/13/2015