Provider First Line Business Practice Location Address:
25 SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44865
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-687-5781
Provider Business Practice Location Address Fax Number:
419-687-5018
Provider Enumeration Date:
06/09/2005