Provider First Line Business Practice Location Address:
2421 ALLENTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805-1711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-225-5238
Provider Business Practice Location Address Fax Number:
419-222-1579
Provider Enumeration Date:
06/04/2009