Provider First Line Business Practice Location Address:
725 S SHOOP AVE
Provider Second Line Business Practice Location Address:
FULTON COUNTY HEALTH CENTER MOB
Provider Business Practice Location Address City Name:
WAUSEON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-534-3111
Provider Business Practice Location Address Fax Number:
419-534-3113
Provider Enumeration Date:
05/03/2007