Provider First Line Business Practice Location Address:
300 ARLINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOGAN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43138-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-385-2155
Provider Business Practice Location Address Fax Number:
740-380-2502
Provider Enumeration Date:
08/20/2008