Provider First Line Business Practice Location Address:
112 COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
26-676-5275
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2011