Provider First Line Business Practice Location Address:
200 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
STE 2K
Provider Business Practice Location Address City Name:
HAZARD
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41701-9466
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-487-8063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2006