Provider First Line Business Practice Location Address:
145 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON COURT HOUSE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-333-7102
Provider Business Practice Location Address Fax Number:
740-333-7077
Provider Enumeration Date:
06/01/2009