Provider First Line Business Practice Location Address:
111 SOUTH GRANT AVE
Provider Second Line Business Practice Location Address:
GRANT MEDICAL CENTER
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-566-9221
Provider Business Practice Location Address Fax Number:
614-566-8738
Provider Enumeration Date:
04/23/2008