Provider First Line Business Practice Location Address:
117 N 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43725-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-630-5605
Provider Business Practice Location Address Fax Number:
740-432-4061
Provider Enumeration Date:
08/30/2010