Provider First Line Business Practice Location Address:
610 W MAIN ST
Provider Second Line Business Practice Location Address:
CLINTON CO. MEMORIAL HOSPITAL PATH DEPT
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45177-2125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-382-9262
Provider Business Practice Location Address Fax Number:
937-283-9706
Provider Enumeration Date:
01/25/2006