Provider First Line Business Practice Location Address:
1800 ALLENTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805-1873
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-229-0415
Provider Business Practice Location Address Fax Number:
419-229-0419
Provider Enumeration Date:
10/10/2005