Provider First Line Business Practice Location Address:
7 WEST JACKSON STREET
Provider Second Line Business Practice Location Address:
LOUIS STOKES VAMC PAINSEVILLE OUTPATIENT CLINIC
Provider Business Practice Location Address City Name:
PAINSEVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-357-6740
Provider Business Practice Location Address Fax Number:
440-357-7906
Provider Enumeration Date:
08/16/2006