Provider First Line Business Practice Location Address:
110 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON CH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-1347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-636-0720
Provider Business Practice Location Address Fax Number:
740-636-0780
Provider Enumeration Date:
06/02/2005