Provider First Line Business Practice Location Address:
222 N 5TH ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MARTINS FERRY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43935-1582
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-633-6671
Provider Business Practice Location Address Fax Number:
740-633-6679
Provider Enumeration Date:
10/14/2005