Provider First Line Business Practice Location Address:
646 N SANDUSKY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER SANDUSKY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43351-1028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-294-2125
Provider Business Practice Location Address Fax Number:
419-294-2866
Provider Enumeration Date:
09/12/2006