Provider First Line Business Practice Location Address:
215 CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUDDY
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-353-7306
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/13/2020