Provider First Line Business Practice Location Address:
116 BUCKHORN LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUCKHORN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41721-8987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-398-7000
Provider Business Practice Location Address Fax Number:
606-398-7912
Provider Enumeration Date:
03/12/2007