Provider First Line Business Practice Location Address:
4121 N KING RD
Provider Second Line Business Practice Location Address:
KINGSTON CARE CENTER
Provider Business Practice Location Address City Name:
SYLVANIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-517-8200
Provider Business Practice Location Address Fax Number:
419-517-8208
Provider Enumeration Date:
07/05/2005