Provider First Line Business Practice Location Address:
551 W HIGH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PHILADELPHIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-339-4466
Provider Business Practice Location Address Fax Number:
330-339-9007
Provider Enumeration Date:
09/28/2006