Provider First Line Business Practice Location Address:
327 KY ROUTE 550
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTERN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41622-6925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-358-4800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2021