Provider First Line Business Practice Location Address:
7363 SULPHUR WELL KNOB LICK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOB LICK
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42154-8391
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-453-3792
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/06/2009