Provider First Line Business Practice Location Address:
13988 E HIGHWAY 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRVINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40146-7165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-756-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2025