Provider First Line Business Practice Location Address:
920 W MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805-2773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-222-2273
Provider Business Practice Location Address Fax Number:
419-222-6261
Provider Enumeration Date:
01/19/2007