Provider First Line Business Practice Location Address:
HWY 190
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRAKES
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-337-2758
Provider Business Practice Location Address Fax Number:
606-337-2928
Provider Enumeration Date:
09/04/2007