Provider First Line Business Practice Location Address:
5700 MONROE ST
Provider Second Line Business Practice Location Address:
SUITE 211 PROMEDICA HEALTH AND WELLNESS CENTER
Provider Business Practice Location Address City Name:
SYLVANIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-935-5393
Provider Business Practice Location Address Fax Number:
734-243-3236
Provider Enumeration Date:
05/23/2007