Provider First Line Business Practice Location Address:
141 S 11TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43725-2464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-439-6647
Provider Business Practice Location Address Fax Number:
740-439-9303
Provider Enumeration Date:
01/31/2007