Provider First Line Business Practice Location Address:
701 OVERTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41071-2064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-581-1400
Provider Business Practice Location Address Fax Number:
859-581-0126
Provider Enumeration Date:
12/26/2006