Provider First Line Business Practice Location Address:
HWY 127 N, OWENTON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-484-5721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2019