Provider First Line Business Practice Location Address:
429 W CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER SANDUSKY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43351-1038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-294-3469
Provider Business Practice Location Address Fax Number:
419-294-1826
Provider Enumeration Date:
04/22/2011