Provider First Line Business Practice Location Address:
119 HIGH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKFORT
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45628-0312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-998-4779
Provider Business Practice Location Address Fax Number:
740-998-4801
Provider Enumeration Date:
11/02/2006