Provider First Line Business Practice Location Address:
530 N MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC ARTHUR
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45651-1131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-596-2566
Provider Business Practice Location Address Fax Number:
740-596-2155
Provider Enumeration Date:
04/18/2007