Provider First Line Business Practice Location Address:
120 W DUDLEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAUMEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-893-1971
Provider Business Practice Location Address Fax Number:
419-893-2321
Provider Enumeration Date:
01/30/2007