Provider First Line Business Practice Location Address:
100 W RAMSEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAWSON SPRINGS
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42408-1739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-797-8131
Provider Business Practice Location Address Fax Number:
270-797-3428
Provider Enumeration Date:
06/08/2006